How many pharmacy benefit managers are there?
Christopher Snyder
Published May 15, 2026
Today, there are 66 PBM companies, with the three largest – Express Scripts (an independent publicly-traded company), CVS Caremark (the pharmacy service segment of CVS Health and a subsidiary of the CVS drugstore chain), and OptumRx (the pharmacy service segment of UnitedHealth Group Insurance) – controlling
Herein, who are the major pharmacy benefit managers?
The major companies in the global the Pharmacy Benefit Management Market are CVS Health, Express Scripts, OptumRx, Inc., Anthem, Inc., Centene Corporation, CIGNA, MedImpact.
Furthermore, are pharmacy benefit managers necessary? Today, health care plans hire PBMs to secure lower costs for prescription drugs, passing the savings directly to patients. PBMs are your first line of defense against rising prescription drug costs. They work to ensure lower costs and better health outcomes through affordable access to medicines you need.
Also to know, who is the biggest PBM?
CVS Health had the largest share of the pharmacy benefit manager market in 2020. In total CVS Health held 32 percent of the market at that time. Pharmacy benefit managers are an important part of the prescription drug supply chain.
What is an example of a pharmacy benefit manager?
Example of PBMs: CVS/caremark
According to the CVS/caremark website: "Whether plan members access their prescriptions by mail or in one of our national network's more than 68,000 retail pharmacies, we provide the service and support needed to make sure the process goes smoothly.
Related Question Answers
Is McKesson a PBM?
Why CVS Health and Express Scripts Sold—and McKesson Bought—a Specialty Hub Business. CVS Health and Express Scripts divest businesses that could be perceived to conflict with their pharmacy benefit manager (PBM) business. McKesson deepens its investment in non-wholesaling manufacturer services for specialty products.Who owns pharmacy benefit managers?
In March 2015 UnitedHealth Group acquired Catamaran Corporation for about $12.8 billion to extend this PBM business.Is Humana a PBM?
Both Anthem and Humana have launched their own in-house PBMs, but they haven't gained much traction.What do pharmacy benefit managers do?
PBMs increase a patient's access to medications by negotiating directly with drug manufacturers or wholesalers. PBMs negotiate discounts from Wholesale Acquisition Cost (WAC) for quantity discounts that they are able to pass on to their clients. They also negotiate payments based on adherence programs.Is optum a PBM?
As a pharmacy benefit manager (PBM), our goal is to improve the affordability of health care and prescription drugs for both plan sponsors and members.Is Walgreens a pharmacy benefit manager?
and Walgreens Boots Alliance, Inc. announced plans Thursday to create an "innovative model for pharmacy management" through RxAdvance, a cloud-based pharmacy benefit manager (PBM).Who are the top 5 PBMs?
Top 10 Pharmacy Benefit Management (PBM) Companies- OptumRx.
- MedImpact Healthcare Systems, Inc.
- Express Scripts.
- CVS Caremark.
- WithMe Health.
- EmpiRx Health.
- WellDyne.
- Prime Therapeutics.
What is wrong with PBMs?
Although the primary function of a PBM initially was simply to create networks and process pharmaceutical claims, these entities have exploited the lack of transparency and created conflicts of interest which have significantly distorted competition, reduced choices for consumers and ultimately increased the cost ofHow do PBM make money?
In addition to monetizing prescriptions themselves, PBMs also gain profits through administrative and dispensing fees, rebates, group purchasing organizations, research grants, sale of claims data, prior authorizations, and valued added programs.Do PBMs exist in other countries?
There is federal legislation being reviewed now that would stop rebates from manufacturers to PBMs. You have probably seen that drug prices in other countries are much less. That's because PBMs only exist in the United States.What are DIR fees?
DIR fees are the result of a loophole in Medicare regulations. Often more than half a year after a pharmacy fills a Medicare prescription, payers are taking back money paid to pharmacies. Payers are claiming they are taking back money due to a pharmacy's performance on so-called quality measures.What is a specialty area of pharmacy?
Specialty pharmacy focuses on high cost, high touch medication therapy for patients with complex disease states. In this setting, pharmacists may work in a variety of areas including dispensing, medication therapy management, patient advocacy and therapy compliance.Who is Walmart PBM?
Walmart on Tuesday separately announced a partnership with Capital Rx, a pharmacy benefit manager (PBM) startup that provides health plans with information on prescription drug prices.How does GoodRx make money?
GoodRx makes money by selling its technology and ads, as well as through referral fees and a subscription service (its main website and app, with comparative pricing and discounts are free, though). It says it has helped 100 MILLION Americans save more than $10 billion on prescription drugs.Who are PBM clients?
CVS Caremark helps a variety of pharmacy benefit management (PBM) clients, which include employers, unions, health plans and government payors, control rising drug prices.Is CVS a pharmacy benefit manager?
CVS Health has been the pharmacy benefit manager for the Service Benefit Plan, which has provided benefits to the federal workforce, since 1993.What is the difference between a PBM and a payer?
Payer claims data is a list of medications where a claim was filed. The Pharmacy Benefit Manager (PBM) is the payer and stores a list of medications specific to each patient. Pharmacy Fill data is a list of medications filled by a pharmacy for the patient.Who uses GoodRx?
More than 70,000 pharmacies in the United States — including major chains like Costco, Kroger, Walmart, CVS, Rite Aid and Walgreens — will accept GoodRx. When you search GoodRx for your medication, you'll see all of the pharmacies on the drug price page.What does PBM mean in an address?
PBM| Acronym | Definition |
|---|---|
| PBM | Personal Broadband Mobile (Wireless Networks) |
| PBM | Pay By Mail |
| PBM | Permanent Bench Mark (surveying) |
| PBM | Parent Behind Me (chat) |
