PBM Platform Companies 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.

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

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

The new PBM Platform Companies Overview offers comprehensive intelligence on over 25 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.

AMI recently published its PBMs 2022 Annual Review that segments the market into Market Leaders, Mid-Market PBMs, and the growing segment of Non-Traditional PBMs.

Table of Contents

PBM Market

• Background – pgs. 4-5

 

PBM Platform Company Profiles

• Abarca Health – pgs. 7-11
• Agadia Systems – pgs. 12-14
• Cadence Rx, Inc. – pgs. 15-17
• EHO360 – pgs. 18-21
• Elixir/Laker Software – pgs. 22-26
• Excellarate – pgs. 27-29
• Gainwell Technologies – pgs. 30-33
• Infostretch Corporation – pgs. 34-35
• Levrx Technology Inc. – pgs. 36-39
• MC-Rx – pgs. 40-43
• Milliman Dynamic Pharmacy Analytics – pgs. 44-46
• nirvanaHealth/RxAdvance – pgs. 47-52
• PharmPix Corporation – pgs. 53-56
• Prescryptive Health – pgs. 57-61
• Procella Health – pgs. 62-63
• Rightway Healthcare – pgs. 64-67
• RxBenefits Inc. – pgs. 68-71
• RxLogic – pgs. 72-73
• RxRevu – pgs. 74-78
• RxSense – pgs. 79-83
• Scripta Insights – pgs. 84-86
• SmithRx – pgs. 87-89
• SS&C/DomaniRx – pgs. 90-93
• Tredium Solutions – pgs. 94-95
• Truveris – pgs. 96-100
• VativoRx – pgs. 101-104
• Xevant – pgs. 105-108