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Directory of Pharmacy Benefit Managers - PBMs

Index to Pharmacy Benefit Managers (PBMs) in the United States.


 

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

 

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AmeriHealth Mercy/PerformRx
100 Stevens Drive
Philadelphia, PA 19113

Visit PerformRx's Web Site

Visit AmeriHealth Mercy's Web Site

PerformRx is a proven, pharmacy care management solution that meets financial objectives while improving the quality of health care for members of HMOs, states and other selected groups. PerformRx uses a unique approach that links traditional medical management with pharmacy benefit management. With a specialty in Medicaid managed care, PerformRx has maintained an average annual pharmacy cost trend of less than 8% versus the national trend of 18%-25% in the Medicaid sector.
 

Anthem Prescription Management
8990 Duke Boulevard 
Mason, OH 45040 

Visit Anthem's Web Site

Anthem Prescription Management: Total Pharmacy Solutions Provider

Anthem Prescription’s approach is distinctly different from other Prescription Benefit Managers. Our prescription solutions approach has evolved from our health plan heritage. We understand and optimize the advantages of the regional health plan. We also understand that many of the common practices in the PBM industry may extract value from the membership it's designed to serve.
 

Argus 
1300 Washington Street 
Kansas City, MO  64105 

Visit Argus' Web Site

Argus is a technology pioneer providing leading-edge healthcare improvement services to the nation's key healthcare organizations for 24 million lives. 

An independent company, Argus offers broad-based services: rebate contracting solutions with full disclosure, web-enabled rebate administration & multi-dimensional ad-hoc analysis, and retail & specialty pharmacy networks. 

 

 

 
 

 

 

Caremark Inc. 
2211 Sanders Rd. 
Northbrook, IL  60062 

Visit Caremark's Web Site

Caremark Inc. is a leading pharmaceutical services company providing comprehensive drug benefit services to over 2,000 health plan sponsors and their plan participants throughout the U.S. and Puerto Rico. Caremark provides services to a broad array of clients including corporate health plans, managed care organizations, insurance companies, unions, government agencies and other funded benefit plans. The company operates a national retail pharmacy network with over 57,000 participating pharmacies, seven state-of-the-art mail service pharmacies, the industry's only FDA-regulated repackaging plant and 23 specialty mail service pharmacies for delivery of advanced medications to individuals with chronic or genetic diseases and disorders.  
 


Catalyst Rx, A HealthExtras Company  
800 King Farm Boulevard 
Rockville, MD  20850 

9525 Hillwood Drive
Suite 100
Las Vegas, NV 89134
 

Visit Catalyst's Web Site

Catalyst Rx, a HealthExtras Company, is a full service PBM that specializes in providing effective solutions for employer groups, managed care organizations, third party administrators, and local/state government entities. Founded in 1994, Catalyst Rx’s services include customized clinical programs, flexible formulary management, retail and mail order network management, and specialty pharmacy initiatives. Our commitment to innovation, efficiency and superior customer service has enabled our clients to "beat the trend" in prescription drug costs and has allowed them to balance the management of pharmacy expenses with quality of care. In recognition of this approach, Catalyst Rx was awarded the 2004 Innovative Pharmacy Benefit Management award by PBMI. 
 

Cypress Care 
1845 Satellite Boulevard  Suite 800
Duluth, GA  30097 
 

Visit Cypress Care's Web Site

With the greatest utilization rates and strictest compliance measures in the Workers' Compensation PBM industry, Cypress Care achieves the highest levels of total savings - all at no cost to our customers. Outsourcing the PBM function to us, clients can (with a mouse click) customize, monitor and track individual patient coverage lists. This reduces administrative costs drastically while dramatically improving patient care. By lightening adjusters' administrative burdens, they can adjust claims quickly and drive shorter return to work cycles.  

 

 



 

 

 

 Express Scripts
13900 Riverport 
Maryland Heights, MO 63043 

Visit Express Script's Web Site

Express Scripts, Inc. (Nasdaq: ESRX) makes the use of prescription drugs safer and much more affordable. Express Scripts is one of the largest pharmacy benefit management (PBM) companies in North America. Express Scripts provides integrated PBM services, including network pharmacy claims processing, mail pharmacy services, benefit design consultation, drug utilization review, formulary management, disease management, medical and drug data analysis services and medical information management services. The company also provides distribution services for specialty pharmaceuticals. Express Scripts is headquartered in St. Louis, Missouri. More information can be found at www.express-scripts.com.

 

 

 

 

 

 

HealthTrans
6061 South Willow Drive, Suite 125
Greenwood Village, CO 80111 

Visit HealthTrans' Web Site

HealthTrans, a pharmacy benefits administrator (PBA), provides organizations with cost-effective pharmacy benefits services. Focusing on helping our clients achieve the lowest net drug spend, HealthTrans operates a full-disclosure business model that provides complete visibility into, and control of, all aspects of the pharmacy benefit, and enables clients to achieve long-term savings via value-based preferred drug lists and flexible plan design choices. HealthTrans services include benefits mgmt, clinical programs, formulary/rebates, pharmacy network mgmt, reporting, enrollee/provider mgmt, and consulting.

 

 

 

 

 

 
 

 

 

Kroger Prescription Plans
1014 Vine St 3rd FL 
Cincinnati, OH 45202 

Visit Kroger's Web Site

Kroger Prescription Plans is a leading provider of PBM and mail order pharmacy services nationwide. Since 1993, we have specialized in serving employer groups, union trust funds, government plans, business coalitions, and TPAs. Kroger's mission is to provide superior customer service and value to our clients by improving the health and well-being of plan participants. Kroger accomplishes this through efficient claims processing systems and benefit designs, enhanced formulary management, clinically-sound initiatives, and comprehensive benefits consultation.  
   
 
 

 

 

 
 

 

 

Medco Health Solutions 
14646 N. Kierland Blvd. Ste 250 
Scottsdale, AZ 85254 

Visit Medco Health's Web Site


Medco Health Solutions is the nation’s leading provider of managed prescription drug and health management programs. We serve nearly 65 million people, managing $30 billion in prescription drug expenditures annually on behalf of America’s largest corporations, unions and managed care organizations. With 38+ years of experience, clinical resources and information systems technology, Medco Health leads the industry in effectively managing drug benefits, within the overall goals of improving quality of care and controlling healthcare costs.




MedImpact Healthcare Systems, Inc. 
10680 Treena Street, 5th Floor 
San Diego, CA 92131 

Visit Medimpact's Web Site

MedImpact Healthcare Systems, Inc. is defining new pathways for a diverse healthcare community. Using clinical guidelines, cutting-edge proprietary software tools, and forward thinking business practices, we are the leader in full-service pharmacy benefit management (PBM) programs to meet our clients' individual needs. Our services include claims processing, network management, clinical support, and reporting. From Internet technology to innovative rebate programs, MedImpact delivers solutions to improve the value of health care.



MemberHealth, Inc. 
29100 Aurora Road Suite 301 
Solon, OH 44139 

Visit the MemberHealth website


MemberHealth, Inc. is a full service PBM whose senior management has over a century of experience in the business of prescription drug management. Long viewed as an innovator in the industry, MemberHealth is considered to be the “next generation” PBM. Operating under true financial transparency, MemberHealth provides customizable, cost effective prescription drug programs to employer groups, local and state government bodies, insurance companies, union groups and third party administrators. Our commitment to customer service, flexibility in program design and a national network encompassing over 54,000 pharmacies has positioned MemberHealth as one of the fastest growing PBM’s in the country.

 

 

 

Navitus Health Solutions

999 Fourier Dr, Suite 301
Madison, WI 53717

Navitus is a full-service PBM with corporate headquarters in Wisconsin. Our business model is fully transparent, with complete pass-through of all discounts and rebates to our clients. Navitus is committed to lowering drug costs, improving health and providing superior customer service in a manner that instills trust and confidence. Navitus is focused on delivering the most clinically appropriate, patient centric, value-based programs and services available. The results are clear; long term solutions to increasing costs and significant savings to our clients.


NBRx

3120 West Carefree Highway, Suite 1 PMB #136
Phoenix, AZ 85086

NBRx is a full service national pharmacy benefit program offered through National Benefit Resources (NBR). The program is designed to offer cost effective, flexible, and innovative pharmacy plan designs. A network of over 53,000 national retail pharmacies and a state of the art home delivery system allows for easy access. NBR has been servicing third party administrators and brokers since 1984.
 

NMHC
26 Harbor Park Drive 
Port Washington, New York 11050 

Visit NMHC's Web Site

While clients historically have chosen NMHC for the strength of our traditional PBM services, now plan sponsors are embracing our innovative Total Healthcare Solutions approach.  

The focus of NMHC's Total Healthcare Solutions is on outcomes - better health outcomes for members and better cost outcomes for plan sponsors. This unique approach is based on our ability to access and analyze a rich set of pharmacy and medical claims data across the entire health plan.  With this information and intelligence in hand, we can predict member health outcomes based on claims history and benchmarks, communicate with physicians, pharmacists and patients, and help intervene with improved care and cost-controlling strategies.
 

 

 

 

 

 

Partners Rx Management, LLC 
1717 W. Northern Ave Suite 200
Phoenix, AZ 85021

Visit Partners Rx's Web site 

Concerned about rising drug costs and not compromising quality? Pharmacy benefit management is a complex decision process - one false move and you alienate your membership or overwhelm your budget. We have a proven, Lowest Total Cost model that delivers a rational, crystal clear management strategy, supported by a service and operational excellence culture. Challenge us to prove it to you! Contact us today for a free Claims Replay analysis. Partners Rx Management, LLC(www.partnersrx.com)
 

Pequot Pharmaceutical Network 
PO Box 3560 
Mashantucket, CT  06339 

Visit Pequot Pharmaceutical Network's Web Site

 

PharmaCare 
695 George Washington Highway 
Lincoln, RI  02865 

Visit PharmaCare's Web Site

PharmaCare is one of the largest pharmaceutical benefit management companies in the country. PharmaCare helps large employers, managed care organizations, insurance companies, unions and government agencies make safe, cost effective drug decisions for over 30 million Americans. The company’s comprehensive PBM services include fully integrated state-of-the art mail-service pharmacies and the largest specialty operation in the country. PharmaCare is a wholly owned subsidiary of CVS Corporation. Visit us at www.pharmacare.com
 

Pharmaceutical Care Network 
9343 Tech Center Drive, Suite 200 
Sacramento, CA 95826 

Visit Pharmaceutical Care Network's Web Site

 Pharmaceutical Care Network (PCN) is a full-service PBM and healthcare information company recognized for its excellence in customer care and innovative products and services guiding positive outcomes - both clinical and financial. PCN’s MedIntelligence decision support products ensure intelligent use of pharmacy data and generate intervention communications for improved therapeutic outcomes.


  
Prescription Solutions 
3515 Harbor Blvd 
Costa Mesa, CA 92626 

Visit Prescription Solution's Web Site

Founded in 1993 by pharmacists, Prescription Solutions offers comprehensive pharmacy and medical management services to clients nationwide. Our goal is to impact total healthcare costs – not just pharmacy – while improving quality of life and increasing patient satisfaction. Integrating your pharmacy and medical benefits is the only way to ensure you get real value from your health care benefits: improved outcomes at the lowest attainable cost. It’s an approach that enables us to provide short-term savings and long-term results – healthier employees, fewer sick days, increased productivity.
 

 

Prime Therapeutics
PO Box 64812 
St. Paul, MN 55164 

Visit Prime Therapeutics Web Site

Prime Therapeutics is transforming the pharmacy benefit industry through a unique business model, financial transparency and an unmatched level of program customization. We offer our clients a comprehensive suite of pharmacy benefit management services, including consumer-directed products and a Medicare-endorsed drug discount card. Additionally, Prime recently launched PrimeMail Pharmacy Services. Prime's mission is to help our clients manage the cost of the prescription benefit while encouraging appropriate and safe pharmacy care.

 

 

 
 

 

 

RegenceRx
100 Southwest Market Street
P.O. Box 1271 MSE12A 
Portland, OR 97207

2890 East Cottonwood Parkway #81
P.O. Box 30270 MS #81
Salt Lake City, UT 84130-0270

Visit RegenceRx's Web Site

Share our success. RegenceRx is a national leader in reducing pharmacy trends, increasing generic utilization, and controlling pharmacy costs.

RegenceRx is a not-for-profit, “Best in Class” program, based on nationally recognized science-based therapeutic drug reviews, clinical summaries and management strategies. We offer both full-service and component PBM management. We have full disclosure of all revenues and fees.

Contact us. We will help you gain control of your pharmacy benefit costs.


RESTAT

11900 W. Lake Park Drive
Milwaukee, WI 53224
800.926.5858

Visit RESTAT's Web Site

A member of the Dohmen family of companies, RESTAT simplifies the purchase and use of healthcare services through independent benefits management. As the largest independent PBM, RESTAT has no ownership ties to drug manufacturers or distribution channels, making it uniquely positioned to provide customers with unbiased benefit management solutions. With more than 25 years of experience managing pharmacy benefits, RESTAT is also one of the world’s most experienced benefit managers. Today, more than 4,200 companies, ranging in size from the Fortune 50 to small managed care organizations rely on RESTAT to manage the prescription benefit for over 7.5 million people nationwide.  RESTAT recently launched Align, a completely new pricing model that replaces traditional pricing methodology based upon AWP (average wholesale price) with simple cost-plus fee for service pricing.  We work with employers and a nation-wide, large pool of pharmacies to liberate the marketplace by stimulating competition for the lowest drug cost.  To learn more, visit www.restat.com or call 800.926.5858.                                                                              

RxAmerica, LLC 
221 N. Charles Lindbergh Drive 
Salt Lake City, UT 84116 

Visit RxAmerica's Web Site


RxAmerica is a leading provider of pharmacy benefit management (PBM) services owned by Longs Drug Stores, a Fortune 500 company. With a network of more than 53,000 pharmacies and a state-of-the-art mail service facility, RxAmerica’s clients have pharmacy access in all fifty states as well as Puerto Rico and the Virgin Islands. As one of the nations leading PBM’s, RxAmerica delivers comprehensive prescription management services that lower prescription benefit costs for clients while improving healthcare access, service and treatment for covered members.
 

 

RxWEST
9 Inverness Drive, East 
Englewood, CO 80112 

Visit RxWest's Web Site

RxWEST is a national prescription drug benefit manager, organized to provide customers with an aggressively managed cost containment vehicle. RxWEST features a comprehensive range of health and pharmacy management services including a national mail service pharmacy, over 50,000-retail network pharmacies, health-related product information and other tools designed to maximize pharmacy benefits and control costs. 
 

 

 

Scrip Solutions 
100 Clearbrook Road 
Elmsford, NY 10523 

Visit Scrip Solutions' Web Site

ScripSolutions is the primary operating subsidiary of MIM Corporation, a publicly traded (NASDAQ:MIMS) pharmaceutical healthcare organization founded in 1994 and headquartered in Elmsford, New York. ScripSolutions is composed of two primary lines of business, including its specialty pharmaceutical management division BioScrip and its pharmacy benefit management service ScripPBM. ScripSolutions operates nationally, contracting with healthcare sponsors including managed care organizations, employers, and third party administrators to provide comprehensive pharmaceutical healthcare services. Visit www.scripsolutions.com for more information. 
 
 
 

 
Serve You Custom Prescription Management 
9051 W. Heather Ave
Milwaukee, WI 53224

Visit Serve You Custom Prescription Management's Web site

Serve You Custom Prescription Management provides pharmacy benefit management services to self-insured employers, third party administrators, insurance carriers, HMOs, and other payer groups throughout the U.S. Specializing in customized solutions, flexibility, and superior service, the company’s capabilities include prescription claims processing, formulary and rebate management, clinical programs, custom reporting capabilities, integrated mail service and retail pharmacy networks, custom benefit plan design and management, and consultative services. The company maintains a national retail pharmacy network with over 52,000 participating pharmacies and owns and operates a mail service facility. 
 
 

SXC Health Solutions, Inc.
2505 S. Finley Rd., Ste. 110 
Lombard, IL 60148-4867 
Visit SXC's Web Site Visit SXC's Web Site 


PBM Services: Your Market, Your brand! In a few simple words, it’s about controlling your own prescription drug benefit program. SXC’s model supports your objectives with a full range of tailored services to enable you to effectively take greater control of strategic components of your pharmacy program along with full disclosure and transparent pricing. Built on proven industry business experience, SXC offers multiple solutions that include: claims processing, pharmacy network management services, data warehousing, rebate management, web-interface, dispensing systems and transaction distribution.
 
 

 

 

 

Tmesys 
5483 West Waters Avenue, Suite 1200 
Tampa, FL. 33634 
800-229-5000
 

Visit the PMSI-Tmesys website


Founded in 1992, Tmesys is one of today’s leading and most experienced PBMs specifically devoted to workers’ compensation. Providing discount pricing, instant point of sale prescription claims adjudication, and proactive program compliance capabilities, Tmesys dramatically reduces administrative burdens and saves payors’ money, while delivering up to 80% program penetration. Our complete end to end system identifies and eliminates unnecessary costs while optimizing health outcomes at every step, from “risk-free’ first-fill, to state-of-the-art bill review, advanced clinical analysis and customized reporting programs.

 
Total Script 
10901 W. 120th Avenue Suite 175 
Broomfield, CO 80021 

Visit the Total Script Web Site

Founded in 1997, Total Script is a pharmacy benefit management company gaining national recognition for our prescription discount structure, our reputation for premium customer service and our partnering methodology towards clients and business relationships.  Total Script's executive management team used it's nearly sixty years of industry experience to develop a straight-forward business model that focuses on delivering maximum value to the client.  It is becoming increasingly vital that plan sponsors fully understand their prescription drug pricing structure.   Total Script recognizes this, thus a business model was developed that focuses on educating the client and delivering a plan that controls costs.  Total Script offers a full line of services to self-insured and insured clients, brokers and consultants and third party administrators (TPA's.)

 

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US Script, Inc. 
2425 W. Shaw Avenue 
Fresno, CA  93711 

Visit US Scripts' Web Site


We are a specialty managed care and Pharmacy Benefit Management ("PBM") company. We provide health care management and administration services on behalf of clients that include health maintenance organizations, health insurers, third-party administrators, employers and union-sponsored benefit plans. Our fully integrated PBM services include network claims processing, mail pharmacy, benefit design consultation, drug utilization review, formulary management, disease management, medical and drug data analysis, medical information management, disease management support and outcome assessments.

 

 

 
 

 

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Walgreens Health Initiatives 
1417 Lake Cook Road MS L457 
Deerfield, IL 60015 

Visit Walgreens Health Initiatives' Web Site

Walgreens Health Initiatives, part of the 100-year-old Walgreen Co., is a leader in pharmacy benefit management. We promote employee health—while controlling costs—with innovative solutions tailored to the needs of our clients:

  • Comprehensive programs—with 54,000+ network pharmacies, mail service, formulary management, clinical programs, and a cost-effective specialty pharmacy program
  • Client-specific reporting, advanced claims processing system, and responsive account management 
  • Innovative programs, such as Advantage90™, which allows members to get 90-day supplies of maintenance medication at select retail pharmacies and via mail service
     

 

WebMD Prescription Benefit Solutions 
2045 Midway Drive 
Twinsburg, OH 44087-1933 

Visit WebMD's Web Site

WebMD Prescription Benefit Solutions provides robust prescription claim adjudication solutions and consultative expertise to support the in-sourcing of Prescription Benefit Programs.

VALUABLE ADVANTAGES

  • Complete Financial Transparency
  • Reduced Administrative Costs
  • Client Owned Retail Pharmacy Network Administration
  • Remote User Web Access to Benefit Design Changes
  • Client Owned Rebate Contracts Supported and Administered
  • Easy-to-Use Web based Ad Hoc Reporting Tools
  • Call Center Services

 

WellPoint Pharmacy Management 
8407 Fallbrook Avenue 
West Hills, CA  91304

Visit WellPoint's Web Site

WellPoint Pharmacy Management is an innovative pharmacy benefit manager (PBM) offering the full spectrum of PBM services and quality customer support. We are committed to securing the best solutions and low net costs for our clients.
Whether it's managing drug spend and trend, or maximizing health choices, discover WellPoint Pharmacy Management – a PBM that prides itself on full service and positive outcomes.
 

 

 

 
 

 

 

 
 

 

 

 

 

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