PBM Platform Companies 2023-2024 Overview

Pharmacy Benefit Managers (PBMs) are third party companies that function as intermediaries between insurance providers and pharmaceutical manufacturers. PBMs create formularies, negotiate rebates (discounts paid by a drug manufacturer to a PBM) with manufacturers, process claims, create pharmacy networks, review drug utilization, and more.

The increase in drug prices has increased the attention on PBMs, and the role they play in drug pricing, both at the federal and state levels. PBMs are encountering competition from new pharmacy players, such as Mark Cuban Cost Plus Drugs, and a number of other companies that AMI profiles as non-traditional market participants in the recently published PBMs 2023-2024 Review.

Many pharmacy benefit managers developed their technology platforms for business practices a number of years ago. These practices included a system for eligibility, membership, prescribers, claims, pharmacy network contracts, pricing, benefits, formularies, authorizations, compliance, and more.

Recently, an increasing number of companies have been entering the market with advanced PBM technology platforms. This technology may leverage advanced business intelligence capabilities with data analytics, AI/machine learning, and proprietary technology and be offered to the market as a solution to help drive down the high costs of pharmacy benefits.

The new PBM Platform Companies 2023-2024 Overview offers comprehensive intelligence on over 35 of these companies. The report provides a brief background on the market. Each company profile includes: company background, strategy, top executives, financial/investor information, products and services, and recent activities.

The report is available for $249 for a single-user license. Department and Corporate Licenses are available, please click here.

Table of Contents

PBM Market

• Background – pgs. 4-5

PBM Platform Company Profiles

• Abarca Health – pgs. 7-9
• Agadia Systems – pgs. 10-11
• Arrive Health – pgs. 12-14
• Cadence Rx, Inc. – pgs. 15-16
• Capital Rx – pgs. 17-19
• Cervey, LLC – pgs. 20-21
• EHO360 – pgs. 22-24
• Elixir/Laker Software – pgs. 25-27
• Excellarate – pgs. 28-29
• Exouza, Inc. – pgs. 30-31
• Flipt – pgs. 32-33
• FutureRx – pgs. 34-36
• Gainwell Technologies – pgs. 37-38
• Infostretch Corporation/Apexon – pgs. 39-41
• Levrx Technology Inc. – pgs. 42-44
• MC-Rx – pgs. 45-47
• Milliman Dynamic Pharmacy Analytics – pgs. 48-50
• nirvanaHealth – pgs. 51-53
• PharmPix Corporation – pgs. 54-56
• Prescryptive Health – pgs. 57-60
• Procella Health – pgs. 61-62
• Prodigy Rx – pgs. 63-64
• RedSail Technologies, LLC – pgs. 65-68
• Rightway Healthcare – pgs. 69-72
• RxBenefits Inc. – pgs. 73-76
• RxLogic – pgs. 77-78
• RxPreferred Benefits – pgs. 79-80
• RxSense – pgs. 81-84
• Scripta Insights – pgs. 85-87
• SmithRx – pgs. 88-90
• SPS Health – pgs. 91-92
• SS&C/DomaniRx – pgs. 93-95
• TransactRx – pgs. 96-97
• Tredium Solutions – pgs. 98-99
• Truveris – pgs. 100-102
• VativoRx – pgs. 103-106
• Xevant – pgs. 107-110