PerformRx is a Pharmacy Benefit Manager (PBM) offering PBM solutions to managed care organizations, Medicaid, and Medicare Part D clients. They provide building better benefits, clinical services, client support services, drug therapy management, specialty pharmacy, and PBM technology offerings.

In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and …

Mar 31, 2025 · The PBM business is part of CVS Health’s Health Services segment, which includes CVS Caremark, Cordavis, Oak Street Health, Signify Health, and MinuteClinic. For 2024, Express Scripts’ gain was CVS Caremark’s pain. Total PBM 30-day equivalent claims processed fell by −18.2%, from 2.3 billion in 2023 to 1.9 billion in 2024.

Jan 28, 2025 · CVS Health is the largest PBM (with a 21.3% market share), followed by OptumRx (20.8%), Express Scripts (17.1%) and Prime Therapeutics (10.3%). At the local level, the average PBM market is highly concentrated when measured against federal antitrust guidelines.

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Nov 15, 2022 · PBMs are companies that work as a third party between healthcare insurance providers and pharmaceutical companies. PBMs help control drug costs, public access to medications, and how much payment...

Apr 6, 2021 · For evidence, look no further than Drug Channels Institute's estimates of pharmacy benefit manager (PBM) market share, which are shown in the chart below. For 2020, DCI estimates that the three biggest PBMs accounted for more than three-quarters of total equivalent prescription claims.

Dec 5, 2023 · Here's how the six largest health insurance companies and their pharmacy benefit manager companies stack up. 1. UnitedHealth Group's PBM, Optum Rx, accounted for 22% of the 2022 PBM industry with managed claims. Two other PBMs outpaced Optum Rx in 2022: CVS Health/Caremark (33%) and Cigna/Evernorth/Express Scripts (24%).

Sep 15, 2022 · A pharmacy benefit manager, or PBM, is a third-party service that manages prescription drug programs, acting as an intermediary between drug manufacturers, pharmacies, and health plan sponsors. How does a PBM work?

Jul 10, 2024 · A pharmacy benefit manager, or PBM, is a third-party entity that acts as a middleman between drug manufacturers, insurance providers, employers, and more. Some of the services that PBMs provide include creating and maintaining formularies , negotiating drug prices and rebates, creating pharmacy networks, and processing claims.