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Pharmacy benefit management. 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 state government employee plans. [ 1][ 2] PBMs operate inside of ...
Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2] Express Scripts had 2016 revenues of $100.752 billion. [2]
AdvancePCS. AdvancePCS Inc. (Pharmaceutical Card System) was a large prescription benefit plan administrator from the United States, also known as a PBM (Pharmacy Benefit Manager) . The company was partially purchased by McKesson in 1969 and fully in 1972. In 1994, the company was sold to Lilly for $4.4 billion. [ 1]
US$ 226.6 billion (2023) [ 1] Parent. UnitedHealth Group. Website. www .optum .com /en /. Optum, Inc. is an American healthcare company that provides technology services, pharmacy care services (including a pharmacy benefit manager) and various direct healthcare services. Optum was formed as a subsidiary of UnitedHealth Group in 2011 by merging ...
Three companies controlled 79% of U.S. pharmacy benefit management in 2022, according to the data platform Statista: CVS Caremark with 33%, Express Scripts at 24%, and OptumRx owns 22% of the market.
Catamaran Corporation. Catamaran Corporation (formerly SXC Health Solutions) is the former name of a company that now operates within UnitedHealth Group's OptumRX division (since July 2015). It sells pharmacy benefit management and medical record keeping services to businesses in the United States [ 3] and to a broad client portfolio, including ...
340B Drug Pricing Program. The 340B Drug Pricing Program is a US federal government program created in 1992 that requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices. The intent of the program is to allow covered entities to "stretch scarce federal ...
Instantaneously the pharmacy benefit manager provides coverage data, relaying the patient's out of pocket, or co-pay to the secondary insurer's benefit manager, who then provides a discount accordingly. [citation needed] An example: A brand offers a co-pay card giving patients the opportunity to save up to $20 off each prescription fill.