Pharmacy benefit management (PBM) companies in Texas play a crucial role in the healthcare system, focusing on containing prescription drug costs while enhancing patient care. These firms negotiate with pharmaceutical manufacturers, manage formularies, and assist healthcare providers in optimizing medication use. The industry is evolving rapidly with the integration of technology and data analytics, paving the way for innovative solutions. Increasing emphasis on transparency and accountability reflects a shift toward patient-centered care. As healthcare costs rise, PBMs are expected to innovate further, improving value in the pharmaceutical supply chain and actively contributing to healthier outcomes.

The listed pharmacy benefit management companies in Texas range in size from small firms of fewer than 50 employees to larger organizations with up to 5000 staff. With headquarters in various cities, such as Frisco, Plano, and Dallas, these companies span established names founded as early as 1926 to newer entrants established in recent years. Their operations focus on a variety of specializations, including behavioral health services, specialty pharmacy management, and tailored solutions for self-funded employers, demonstrating a fusion of traditional and modern approaches to pharmacy benefit management.

Continue reading to discover the top pharmacy benefit management companies in Texas.

Top 19 Pharmacy Benefit Management Companies in Texas

1. Magellan Health

• Website: magellanhealth.com
• Ownership type: Corporate
• Headquarters: Frisco, Texas, United States (USA)
• Employee distribution: United States (USA) 98%, Other 2%
• Latest funding: $750.0M, November 2022
• Founded year: 1969
• Headcount: 1001-5000
• LinkedIn: magellan-health

Magellan Health, founded in 1969 and based in Frisco, Texas, is a managed healthcare company that specializes in behavioral health services, pharmacy benefits management, and employee wellbeing solutions. With over 5,000 employees, the company serves a wide range of clients, including health plans, employers, and governmental agencies. Magellan Health is dedicated to improving health outcomes and managing healthcare costs through a person-centered approach. They leverage a large network of providers and emphasize evidence-based solutions to ensure that members receive appropriate treatment in suitable settings. The company has also received substantial funding, with a reported amount of $750 million in November 2022, which supports their ongoing initiatives and innovations in healthcare management.

2. Maxor National Pharmacy Services, LLC

• Website: maxor.com
• Ownership type: Corporate
• Headquarters: Plano, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Latest funding: January 2014
• Founded year: 1926
• Headcount: 1001-5000
• LinkedIn: maxor-national-pharmacy-services-corp-

Maxor National Pharmacy Services, LLC is a healthcare management company based in Plano, Texas, specializing in pharmacy services. Founded in 1926, Maxor has evolved from a corner drug store into a significant player in the pharmacy services industry. The company operates several divisions, including MaxorPlus, Maxor Specialty, and Maxor Pharmacy Services, each focusing on different aspects of pharmacy management. Maxor provides pharmacy benefit management solutions that help healthcare providers and organizations enhance operational efficiency and improve patient care. Their services include comprehensive on-site pharmacy management, 340B program compliance, and specialty pharmacy services. With a workforce of over 1,000 employees, Maxor is dedicated to transforming pharmacy care through innovative solutions and a patient-centered approach.

3. VerusRx

• Website: verus-rx.com
• Ownership type: Private
• Headquarters: Dallas, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2021
• Headcount: 201-500
• LinkedIn: verusrx

VerusRx, based in Dallas, Texas, is a pharmacy benefits management company that aims to control prescription drug costs while improving health outcomes for employees. Founded in 2021, the company primarily serves self-funded organizations and third-party administrators. VerusRx offers a range of services, including the Gio app, which assists members in managing their pharmacy needs effectively. The company emphasizes transparency in its pricing structure, ensuring clients understand their costs without hidden fees. VerusRx is committed to providing tailored solutions, allowing clients to customize their pharmacy benefits plans. Their focus on customer service is evident, with a dedicated team available to resolve issues and provide support. This approach positions VerusRx as a proactive player in the pharmacy benefits management sector, addressing the critical need for cost control and enhanced service delivery.

4. Script Care, Ltd.

• Website: scriptcare.com
• Ownership type: Private
• Headquarters: Beaumont, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 1986
• Headcount: 51-200
• LinkedIn: script-care-ltd-

Script Care, Ltd. is a privately owned pharmacy benefits manager based in Beaumont, Texas. Founded in 1986, the company has built a reputation for providing a range of services that include claims processing, clinical management, and customer support. Script Care serves a variety of clients, including health plans, pharmacies, and consumers, focusing on efficient management of prescription drug benefits. The company prides itself on its commitment to superior customer service, offering 24/7 support with multi-lingual representatives. Their innovative approach to plan design and emphasis on analytics and reporting further enhance their service offerings. Script Care is also noted for its involvement in the 340B program, providing specialized services to help clients navigate the complexities of this federal drug pricing program. With a workforce of approximately 86 employees, Script Care remains a significant player in the pharmacy benefits management industry, dedicated to delivering tailored solutions to meet the unique needs of its clients.

5. PharmPix Corp

• Website: pharmpix.com
• Ownership type: Private
• Headquarters: Irving, Texas, United States (USA)
• Employee distribution: Puerto Rico 95%, United States (USA) 5%
• Founded year: 2009
• Headcount: 51-200
• LinkedIn: pharmpix-corporationpr

PharmPix Corp, based in Irving, Texas, is a pharmacy benefit management company that specializes in providing innovative technology solutions aimed at helping health plans, insurers, and employers manage their pharmacy benefit costs. Established in 2009, PharmPix has developed its OneArk™ Suite, a comprehensive platform that facilitates real-time claims adjudication and offers detailed reporting capabilities. This system is designed to improve healthcare outcomes while reducing expenses for its clients. The company serves a wide range of clients, including health plans, PBMs, and other plan sponsors, managing various programs such as Medicare, Medicaid, and commercial health plans. With a workforce of approximately 107 employees, the majority of whom are based in Puerto Rico, PharmPix emphasizes a flexible and customizable approach to pharmacy benefit management, allowing clients to tailor services to their specific needs. Their operational model includes a mix of in-house services and third-party partnerships, enhancing their ability to deliver effective solutions. PharmPix operates across all 50 U.S. states and territories, showcasing its extensive reach in the industry.

6. CerpassRx

• Website: cerpassrx.com
• Ownership type: Private
• Headquarters: The Colony, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2015
• Headcount: 51-200
• LinkedIn: healthcare-highways-rx

CerpassRx, based in The Colony, Texas, is a private healthcare service provider specializing in pharmacy benefits management. Founded in 2015, the company has grown to employ between 51 and 200 individuals, all based in the United States. CerpassRx offers a range of services, including pharmacy benefits management, pharmacy discount cards, and workers' compensation solutions. The company serves a variety of clients, including employers and third-party administrators, with a focus on enhancing member experience through tailored solutions. CerpassRx prides itself on its high client satisfaction scores and has been recognized as a Great Place to Work, reflecting its commitment to employee engagement and satisfaction. Their clinical portfolio includes over 15 solutions aimed at driving positive health outcomes while delivering cost savings to clients. CerpassRx positions itself as an alternative to traditional PBM models, emphasizing collaboration and a personalized approach to pharmacy benefits.

7. Pharmaceutical Strategies Group - PSG

• Website: psgconsults.com
• Ownership type: Corporate
• Headquarters: Dallas, Texas, United States (USA)
• Employee distribution: United States (USA) 93%, Australia 3%, Saudi Arabia 3%
• Latest funding: February 2021
• Founded year: 1994
• Headcount: 51-200
• LinkedIn: psgconsults

Pharmaceutical Strategies Group (PSG), founded in 1994 and based in Dallas, Texas, is a consulting firm that specializes in pharmacy benefits management. With a workforce of approximately 242 employees, PSG offers a range of services designed to help clients, including employers and health plans, navigate the complexities of drug cost management. Their expertise spans various areas such as audits, clinical optimization, and analytics, which are essential for managing pharmacy benefits effectively. PSG's proprietary analytics platform, Artemetrx, provides clients with actionable insights to enhance program performance. The firm has generated significant drug cost savings, amounting to over $7 billion in 2023 alone, and has represented millions of lives in procurement activities. PSG's commitment to independent advocacy ensures that they act solely in the best interest of their clients, making them a notable player in the pharmacy benefit management sector.

8. Alluma

• Website: allumaco.com
• Ownership type: Private
• Headquarters: Irving, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2019
• Headcount: 11-50
• LinkedIn: alluma-llc

Alluma, founded in 2019 and based in Irving, Texas, operates as a Pharmacy Benefits Manager (PBM) dedicated to enhancing pharmacy benefits for self-insured health systems and employers. The company prides itself on its focus on clinical collaboration, transparency, and data analytics, aiming to improve health outcomes while effectively managing costs. Alluma's services include a technology-enabled platform designed to streamline the pharmacy benefits experience for clients and their members. By partnering with organizations like Mayo Clinic and Vizient, Alluma leverages clinical expertise and insights to optimize pharmacy resource management. Their model emphasizes a patient-centered approach, seeking to align incentives between health systems and their pharmacy benefits, thereby fostering a more equitable marketplace. Alluma's innovative strategies and commitment to transparency position it as a noteworthy player in the pharmacy benefit management sector.

9. Eho360

• Website: ehorx.com
• Ownership type: Private
• Headquarters: Belton, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 1993
• Headcount: 11-50
• LinkedIn: eho

Eho360, based in Belton, Texas, is a pharmacy benefit manager that has been serving clients since 1993. The company focuses on providing comprehensive pharmacy benefit management services tailored to specific sectors, including self-funded plans, hospice care, workers' compensation, and correctional facilities. Eho360 utilizes its proprietary PBM360™ platform to streamline claims processing and enhance operational efficiency. This platform allows for real-time data access and customized plan designs, which are essential for managing the complexities of pharmacy benefits. Eho360 prides itself on its customer service, offering 24/7 support and proactive account management to help clients navigate the challenges of rising drug costs and regulatory changes. The company has not reported any funding, indicating it operates as a privately held entity with a focus on sustainable growth and client satisfaction.

10. Prodigy Care Services

• Website: prodigyrx.com
• Ownership type: Private
• Headquarters: Austin, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2020
• Headcount: 11-50
• LinkedIn: prodigyrxcare

Prodigy Care Services is a healthcare services technology company based in Austin, Texas, founded in 2020. The company specializes in Pharmacy Benefits Management (PBM) and Post-Acute Care solutions, catering primarily to payers such as insurance companies and employers. Prodigy aims to enhance patient outcomes while effectively managing healthcare costs. Their offerings include medical drug rebates, bill negotiation, and facility medication management, all designed to improve efficiency in the healthcare sector. The team at Prodigy consists of clinicians, claims professionals, and industry veterans who are dedicated to patient advocacy and transparency. They emphasize a client-centric approach, boasting a 100% client retention rate and an average savings increase of over 35% for their clients. Prodigy operates with a commitment to delivering evidence-based solutions that simplify processes for claims professionals and clinicians, ultimately striving to elevate the standard of care across the continuum of healthcare services.

11. Leaf Health

• Website: leafhealth.net
• Ownership type: Private
• Headquarters: Leander, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2017
• Headcount: 1-10
• LinkedIn: leaf-health

Leaf Health, founded in 2017 and based in Leander, Texas, is a consulting firm dedicated to pharmacy benefits management. With a team boasting over three decades of industry experience, Leaf Health focuses on providing customized solutions to businesses and organizations. Their services include pharmacy benefits consulting, contract negotiation, and access to discount programs aimed at managing pharmacy spending effectively. The firm emphasizes a high-touch, customer-focused approach, ensuring that each client receives tailored strategies to meet their unique needs. Leaf Health operates as an advocate for its clients, striving to control healthcare costs while maintaining quality patient care. Their innovative solutions, such as the myleafRx Prescription Drug Discount Card, further illustrate their commitment to improving health outcomes and managing costs in a challenging healthcare environment.

12. RxEDO, Inc.

• Website: rxedo.com
• Ownership type: Private
• Headquarters: Plano, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2003
• Headcount: 11-50
• LinkedIn: rxedo-inc.

RxEDO, Inc., founded in 2003 and based in Plano, Texas, is a healthcare consulting company that specializes in prescription benefit management. The firm offers a range of services aimed at helping self-funded employers and health plans manage their prescription drug costs effectively. Their approach is built on principles of transparency and integrity, which they believe are essential for fostering trust and delivering value to their clients. RxEDO provides pharmacy savings programs and Medicare Part D solutions, demonstrating their commitment to addressing the unique needs of their clients. Over the years, they have expanded their service offerings to include solutions for insurers and related service companies, reflecting their adaptability in a changing market. The company prides itself on educating clients about PBM practices, including both disclosed and undisclosed revenue sources, which is crucial for informed decision-making in the management of prescription benefits.

13. Heritage Health Solutions

• Website: heritagehealthsolutions.com
• Ownership type: Corporate
• Headquarters: Coppell, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Latest funding: March 2022
• Founded year: 2005
• Headcount: 11-50
• LinkedIn: heritage-health-solutions

Heritage Health Solutions, based in Coppell, Texas, is a health care management company founded in 2005. With a workforce of 11-50 employees, the company specializes in integrated pharmacy and medical services. Heritage Health Solutions provides a range of offerings, including Pharmacy Benefit Management (PBM), addiction support, and telemedicine. They primarily serve commercial entities, corrections facilities, and government agencies, focusing on reducing healthcare costs while enhancing patient care through tailored solutions. Their extensive experience in the public sector has allowed them to establish a robust network of preferred pharmacies, ensuring that clients receive the necessary drug therapies. Heritage Health Solutions is committed to navigating the complexities of healthcare, providing innovative and effective solutions to meet the evolving needs of their clients.

14. Equipoint Partners, LLC.

• Website: equipointpartners.com
• Ownership type: Private
• Headquarters: Mckinney, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2008
• Headcount: 11-50
• LinkedIn: equipointpartners

Equipoint Partners, LLC. is a private company based in McKinney, Texas, founded in 2008. It serves as a third-party administrator and program manager within the healthcare industry. The firm specializes in creating innovative health plans and pharmacy programs, alongside offering consulting services tailored to insurance carriers, brokers, and employer groups. Equipoint Partners aims to control healthcare costs while enhancing the benefits experience for members. Their solutions include secondary health plans, limited medical plans, and pharmacy benefit consulting, among others. The company prides itself on developing strategic partnerships that focus on reducing claims exposure and out-of-pocket costs without sacrificing quality of care. With a team boasting over 150 years of cumulative experience in underwriting, marketing, and risk management, Equipoint Partners is positioned to deliver effective solutions in an evolving healthcare market.

15. Health Delegates, LLC

• Website: healthdelegates.com
• Ownership type: Private
• Headquarters: Plano, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 2013
• Headcount: 11-50
• LinkedIn: health-delegates

Health Delegates, LLC, based in Plano, Texas, is a healthcare consulting company founded in 2013. With a team of 24 professionals, the firm specializes in rebate management and formulary design, offering customized solutions to pharmacy benefit managers (PBMs), health plans, and employer groups. Their services are designed to help clients navigate the complexities of pharmaceutical rebates, ensuring transparency and optimizing healthcare benefits. Health Delegates provides a comprehensive reporting suite that allows clients to gain insights into their rebate management, focusing on actionable data to enhance decision-making. The company is committed to fostering a healthcare environment that balances cost-effectiveness with clinical outcomes, positioning itself as a trusted partner in the PBM industry.

16. The OccuNet Company

• Website: occunet.com
• Ownership type: Private
• Headquarters: Amarillo, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 1998
• Headcount: 201-500
• LinkedIn: occunet

The OccuNet Company, founded in 1998 and based in Amarillo, Texas, is a private healthcare services provider that specializes in innovative cost containment solutions. The company offers a range of services, including Out-of-Network Solutions, Reference-Based Pricing, and Pharmacy Benefit Management through its FairosRx brand. Their approach is centered on helping employers and healthcare plans manage rising healthcare costs effectively. With a team of experienced professionals, The OccuNet Company aims to transform healthcare delivery by challenging traditional methods and advocating for better patient experiences. Their focus on technology and personalized service positions them as a notable player in the healthcare cost containment industry, particularly in the pharmacy benefit management space.

17. RazorMetrics

• Website: razormetrics.com
• Ownership type: Venture Capital
• Headquarters: Austin, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Latest funding: $3.0M, April 2022
• Founded year: 2018
• Headcount: 51-200
• LinkedIn: razormetrics

RazorMetrics, founded in 2018 and based in Austin, Texas, is a healthcare technology firm dedicated to lowering prescription drug costs. The company offers a SaaS-based platform designed to assist self-funded employers and health plans in managing their pharmacy expenditures. By leveraging data analytics and engaging prescribers, RazorMetrics aims to optimize drug formularies and enhance health outcomes for members. Their proprietary Intervention Codex identifies wasteful spending and provides actionable insights to clients. RazorMetrics has received funding, with their last round amounting to over $3 million in April 2022, indicating investor confidence in their business model and growth potential. The company operates entirely within the United States and has a team of professionals with extensive experience in healthcare, pharmacy, and technology, which supports their mission to transform how prescription costs are managed.

18. EZSCRIPTRx

• Website: ezscriptrx.com
• Ownership type: Private
• Headquarters: San Antonio, Texas, United States (USA)
• Employee distribution: United States (USA) 85%, Argentina 15%
• Founded year: 2018
• Headcount: 11-50
• LinkedIn: ezscriptrx

EZSCRIPTRx, founded in 2018 and based in San Antonio, Texas, is a healthcare technology provider dedicated to improving the pharmacy experience. With a team that boasts extensive experience in healthcare and technology, the company focuses on delivering innovative solutions tailored for independent pharmacies and healthcare organizations. Their product suite includes Intelligent Real Time Benefits Verification (iRTBV) and Daily Refill Optimizer, which streamline prescription fulfillment and enhance patient care. By leveraging data analytics, EZSCRIPTRx helps pharmacies optimize their operations, improve medication adherence, and ultimately increase profitability. The company has not reported any funding, indicating a self-sustained growth model as they continue to serve their clients with cutting-edge technology.

19. S/T Health Group

• Website: sthealthgroup.com
• Ownership type: Private
• Headquarters: Stafford, Texas, United States (USA)
• Employee distribution: United States (USA) 100%
• Founded year: 1998
• Headcount: 11-50
• LinkedIn: s-t-health-group

S/T Health Group, founded in 1998 and based in Stafford, Texas, is a healthcare consulting firm specializing in data analytics and management services. The company assists healthcare providers in enhancing operational efficiency and controlling costs, particularly in the complex landscape of pharmaceutical purchasing. Their client base includes various healthcare organizations aiming to improve patient care while effectively managing expenses. S/T Health Group offers a range of services, including cost containment strategies, price verification, and compliance auditing, with a focus on recovering hidden costs and optimizing purchasing strategies. Their involvement in pharmacy benefit management includes auditing services that compare dispensed medications against PBM contracts to ensure accuracy in charges. This analytical approach allows healthcare providers to make informed decisions regarding their pharmacy operations.

Pharmacy Benefit Management Insights: Key Companies in Texas

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