PBMs 2021 Annual Review

The PBM marketplace has consolidated into three market-leading PBMs (Express Scripts/Cigna, CVS Caremark, UnitedHealth/Optum Rx), controlling approximately three-quarters of the market. Consolidation has rewarded the market-leading PBMs as they or their parent companies have experienced strong financial results in 2020.

Over the last few years, the industry has questioned the PBMs retention of the discounts of the negotiations rather than passing them along to the health plan/employer. This increased scrutiny on the role PBMs play in drug pricing has increased focus on the industry in Washington toward changing the current drug pricing structure.

A growing number of new companies that offer more transparent pharmacy benefit management services have entered the market. Many of these companies are offering a pricing model in which it passes 100% of discounts it receives from pharmacies and pharmaceutical companies to the health plan/employer sponsor.

The 2021 PBMs Annual Review, 145 pages, offers comprehensive intelligence on the leading pharmacy benefit managers, segmenting the market into Market Leaders, Mid-Market PBMs, and Non-Traditional PBMs. AMI’s report also provides background on the market.

Each company profile includes: company background, corporate strategy, top executives, financial/investor information, products and services, and recent activities.

The report Table of Contents:

PBM Market

• Background – pgs. 5-7

PBM Market Leader Profiles

• Express Scripts Evernorth – pgs. 9-18
• CVS Health – pgs. 19-24
• OptumRx/UnitedHealth Group – pgs. 25-30
• Prime Therapeutics – pgs. 31-35
• Humana Pharmacy Solutions – pgs. 36-40
• Elixir/Rite Aid – pgs. 41-45
• MedImpact Healthcare Systems – pgs. 46-48
• Envolve Pharmacy Solutions/Centene – pgs. 49-52
• Perform Rx – pgs. 53-55
• Magellan Rx Management/Centene – pgs. 56-60
• IngenioRx/Anthem – pgs. 61-63

Mid-Market PBM Profiles

• Abarca Health – pgs. 65-66
• BeneCard PBF – pgs. 67-69
• Costco Health Solutions – pgs. 70-71
• EHIM – pgs. 72-73
• Integrated Prescription Management – pgs. 74-75
• Kroger Prescription Plans – pgs. 76-77
• MaxorPlus – pgs. 78-79
• MC-Rx/ProCare Rx – pgs. 80-82
• Pharmacy Benefit Dimensions – pgs. 83-84
• Serve You Rx – pgs. 85-87
• SS&C Health – pgs. 88-89
• WellDyne – pgs. 90-92

Non Traditional PBM Profiles

• Advanced Medical Pricing Solutions/Drexi – pg. 94
• Alluma, LLC – pgs. 95-96
• PillPack by Amazon Pharmacy – pgs. 97-98
• Capital Rx – pgs. 99-101
• CerpassRx – pgs. 102-103
• CitizensRx – pgs. 104-105
• ClearScript – pgs. 106-107
• EmpiRx Health – pgs. 108-109
• Flipt – pgs. 110-111
• Gainwell Technologies – pgs. 112-113
• MedalistRx – pgs. 114-115
• MedOne – pgs. 116-117
• Navitus Health Solutions – pgs. 118-120
• PharmPix – pgs. 121-123
• Phoenix Benefit Management – pgs. 124-125
• RxAdvance – pgs. 126-128
• RxPreferred – pgs. 129-131
• RxSense – pgs. 132-134
• SmithRx – pgs. 135-136
• TransparentRx – pgs. 137-138
• True Rx Management Services – pgs. 139-140
• Vivid Clear Rx/Hy-Vee – pgs. 141-142
• WithMe Health – pgs. 143-144