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Pharmacy Benefit Institute of America (PBIA)
Las Vegas, United States
B
11-50 Employees
2009
Key takeaway
The company, PBIA, is dedicated to enhancing excellence in pharmacy benefits management (PBM) through its comprehensive certification programs and training courses. Their offerings include the Certified Pharmacy Benefits Specialist credential and a range of educational modules that provide critical knowledge for effective management of pharmacy benefits.
Reference
Core business
Home - Pharmacy Benefit Management Certification By PBIA
Get the transparency and disclosure demanded in the competitive pharmacy market with PBIA’s in-person & online pharmacy benefit management training courses.
Abound Care RX
Carolina, United States
B
51-100 Employees
-
Key takeaway
AboundCare RX is an innovative pharmacy benefits manager based in Puerto Rico, focused on developing and administering tailored pharmacy benefit programs that enhance the patient experience and drive optimal health outcomes. Their unique services aim to lower costs and improve care for clients of all sizes and industries.
Reference
Core business
AboundCare RX – Pharmacy Benefits Manager
RxBenefits, Inc.
Birmingham, United States
B
101-250 Employees
1995
Key takeaway
RxBenefits is a leading pharmacy benefits optimizer (PBO) that enhances the pharmacy benefits experience by optimizing clinical, financial, and service aspects. Unlike traditional pharmacy benefit managers (PBMs), RxBenefits focuses on delivering exceptional value and service to self-funded clients, ensuring both financial well-being and member health and safety.
Reference
Core business
RxBenefits: The Market-Leading Pharmacy Benefits Optimizer
We are the industry's first technology-enabled pharmacy benefits optimizer, working to provide amazing pharmaceutical benefits to our clients.
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The Preferred Medical
Louisville, United States
B
51-100 Employees
1998
Key takeaway
The company specializes in Pharmacy Benefit Management (PBM) for workers' compensation, offering tailored strategies and comprehensive solutions that enhance clinical outcomes and streamline the management process. Their services include a pharmacy network, pharmacy cards, and individualized formularies, designed to meet specific client goals.
Reference
Product
Pharmacy Benefit Management - Preferred Medical
We provide you with pharmacy benefit management through services such as pharmacy network, pharmacy cards, individualized formularies, and in-network strategies.
Benefit Solutions Group
Dallas, United States
B
1-10 Employees
2020
Key takeaway
The company offers specialized Pharmacy Benefit Management (PBM) consulting services, leveraging advanced insights and industry best practices to deliver measurable outcomes for Pharma, Payor, and Provider clients. Their team of senior consultants and partners brings extensive expertise in pharmacy management, making them reliable strategists in this field.
Reference
Service
Benefit Solutions Group - PBM Consulting, Management Consulting
Your trusted pharmacy strategy and operations experts
Evernorth
St. Louis, United States
B
501-1000 Employees
2020
Key takeaway
Evernorth offers comprehensive Pharmacy Benefits Management (PBM) services, emphasizing their commitment to innovative health solutions that enhance overall well-being. Their approach integrates various health management strategies, including value-based care and vaccination programs.
Reference
Service
Pharmacy Benefits Management Services (PBM) | Evernorth
ClearScript pharmacy benefit management
Minneapolis, United States
B
11-50 Employees
2005
Key takeaway
ClearScript's Pharmacy Benefit Management (PBM) solutions are designed to enhance healthcare plans by reducing drug spending and prioritizing member health. With a strong focus on customer satisfaction and a commitment to leveraging medical and pharmacy expertise, ClearScript aims to improve the overall pharmacy benefit program for employers and healthcare plans.
Reference
Core business
Pharmacy benefit management - ClearScript
ClearScript's pharmacy benefit management leverages medical and pharmacy expertise to reduce drug spend while improving your members' well-being.
MaxCareRx
Edmond, United States
B
11-50 Employees
1985
Key takeaway
The company specializes in providing adaptable pharmacy benefit management solutions designed to fit organizations of all sizes, ensuring transparency and flexibility in managing healthcare costs. Their focus on personalized care and a robust pharmacy network highlights their commitment to enhancing employee wellbeing through tailored health insurance and comprehensive coverage options.
Reference
Product
Pharmacy Benefit Solutions - MaxCare
Pharmacy Data Management (PDMI)
Youngstown, United States
B
101-250 Employees
1984
Key takeaway
PDMI offers comprehensive pharmacy benefit administration services and transparent claims processing specifically designed for Pharmacy Benefit Managers (PBMs). Their commitment to data ownership and accessibility ensures clients have 24/7 access to essential information, empowering them to tailor services to their needs.
Reference
Core business
Pharmacy Claims Processing and Administration | Pharmacy Data Management
Remedy Analytics
Milwaukee, United States
B
51-100 Employees
2013
Key takeaway
Remedy's expertise in data intelligence and clinical insight is crucial for enhancing pharmacy benefit management (PBM), as it helps organizations reduce drug spending and improve health outcomes. Their seasoned professionals provide customized solutions that simplify the complex pharmacy landscape, making prescription drugs more affordable and accessible.
Reference
Core business
Remedy Analytics | Pharmacy Benefit Strategy
Plan sponsors depend on Remedy’s data intelligence and clinical expertise to improve their pharmacy benefits, reduce spend and help manage population health.
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Pharmacy Benefit Management (PBM) providers are organizations that manage prescription drug benefits on behalf of health insurers, employers, and other plan sponsors. They play a crucial role in controlling drug costs and improving patient access to medications. PBMs negotiate with pharmaceutical manufacturers and pharmacies to secure discounts and rebates, ultimately aiming to reduce overall healthcare expenses. Additionally, these providers implement formulary management, which involves creating lists of covered drugs that promote the use of cost-effective therapies. They also offer clinical programs to ensure appropriate medication use, adherence, and safety, making them integral to the healthcare system's efforts in managing prescription drug benefits effectively.
Pharmacy Benefit Management (PBM) providers act as intermediaries between insurers, pharmacies, and drug manufacturers to manage prescription drug benefits. They negotiate with pharmaceutical companies to secure discounts and rebates on medications, which helps to lower costs for health plans and consumers. Additionally, PBMs develop and maintain formularies, which are lists of covered medications. They also implement strategies to manage medication adherence and promote the use of generic drugs. By analyzing data on drug utilization and costs, PBMs aim to enhance the effectiveness and efficiency of medication therapy, ultimately improving health outcomes while controlling expenses.
1. Cost Savings
Pharmacy Benefit Management (PBM) providers help to negotiate discounts and rebates with drug manufacturers, leading to reduced medication costs for both employers and consumers. By managing formularies and promoting the use of generic medications, PBMs can further drive down spending on pharmaceuticals.
2. Improved Health Outcomes
Through medication therapy management and adherence programs, PBMs enhance patient care by ensuring that individuals receive the right medications at the right time. This proactive approach not only improves health outcomes but also reduces hospitalizations and overall healthcare costs associated with medication mismanagement.
Pharmacy Benefit Management (PBM) significantly influences drug pricing through various mechanisms. By negotiating discounts and rebates with pharmaceutical manufacturers, PBMs can lower the overall cost of medications for health plans and consumers. They utilize their purchasing power to secure favorable pricing, which can lead to reduced copays for patients. Additionally, PBMs manage formularies, determining which drugs are covered and at what level. This formulary management can impact drug availability and the associated costs, as preferred medications typically have lower out-of-pocket expenses for consumers. Overall, PBMs play a crucial role in shaping market dynamics and drug pricing strategies.
Pharmacy Benefit Management (PBM) providers face several challenges that can impact their operations and relationships with stakeholders. One significant issue is the complexity of managing formularies and ensuring that the medications covered align with the needs of patients while also controlling costs. This often leads to negotiations with pharmaceutical companies, which can be contentious and time-consuming. Another challenge is the increasing scrutiny from regulators and the public regarding pricing transparency and the role of PBMs in drug pricing. As healthcare costs continue to rise, there is pressure for PBMs to demonstrate their value in managing pharmacy benefits effectively. Additionally, the shift towards value-based care requires PBMs to adapt their models to focus not just on cost savings but also on improving patient outcomes, which can complicate their traditional business practices.
Some interesting numbers and facts about your company results for Pharmacy Benefit Management (Pbm)
Country with most fitting companies | United States |
Amount of fitting manufacturers | 5879 |
Amount of suitable service providers | 7246 |
Average amount of employees | 51-100 |
Oldest suiting company | 1984 |
Youngest suiting company | 2020 |
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Some interesting questions that has been asked about the results you have just received for Pharmacy Benefit Management (Pbm)
What are related technologies to Pharmacy Benefit Management (Pbm)?
Based on our calculations related technologies to Pharmacy Benefit Management (Pbm) are Heat Exchangers, Hydraulic & Pneumatic Systems, Industrial Reactors, Industrial Packaging, Industrial Filters
Who are Start-Ups in the field of Pharmacy Benefit Management (Pbm)?
Start-Ups who are working in Pharmacy Benefit Management (Pbm) are Benefit Solutions Group
Which industries are mostly working on Pharmacy Benefit Management (Pbm)?
The most represented industries which are working in Pharmacy Benefit Management (Pbm) are Healthcare, Pharmaceuticals, Other, IT, Software and Services, Finance and Insurance
How does ensun find these Pharmacy Benefit Management (Pbm) Companies?
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