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Market Access & Reimbursement

Pharmacy Benefit Managers

Formulary, rebate & utilization

20

PBMs listed

Formulary, rebate, reimbursement and utilization-management partners — ranked on reach and program depth.

SearchFaceted, over real records CompareSide-by-side scorecards Post an RFxGet qualified responses CollaborateRun it in a shared room AI assistantYour organisation, this market

Scores & ranking are deterministic, rules-based — not AI · organization names are real PBMs / market-access organizations, all capabilities, covered-lives & performance figures are synthetic demonstration data — not a determination; verify directly & via vendor qualification before sourcing.

MarketplacesPharmacy Benefit Management

20 providers

Sort

PBM capability Formulary influence Contracting depth Specialty management Regulatory reach Performance & quality Name (A–Z)

Therapeutic area

Specialty19 Oncology18 Cardiometabolic16 Immunology12 Rare disease10 Infectious disease8 Cell & gene therapy5 Neurology4 Other1

Covered lives

Any covered lives ≥ 1M covered lives ≥ 5M covered lives ≥ 20M covered lives ≥ 50M covered lives

Ownership

Public10 Private4 Subsidiary4 Insurer-owned2

Specialty network

Any specialty network ≥ 500 pharmacies ≥ 1,000 pharmacies ≥ 2,000 pharmacies

Health-plan reach

Any health-plan reach ≥ 75 health plans ≥ 150 health plans ≥ 250 health plans

Formulary

National formulary Specialty formulary Biosimilar strategy Therapeutic interchange Step therapy Formulary optimization

Reimbursement

Claims processing Medical benefit Specialty reimbursement Copay management Appeals admin

Pricing & contracting

Mfr contracting Rebate admin Value-based Outcomes-based Pricing strategy

Specialty programs

Oncology Rare disease Cell & gene Patient support Adherence

Utilization management

Clinical appropriateness15 Quantity limits12

Status

Verified Accepting partners

Country

China France Germany Japan Switzerland USA United Kingdom

Showing 20 of 20

CVS

Pharmacy Benefit Manager · Woonsocket, RI, USA

100PBM

National formularySpecialty formularyValue-basedOncology

Value-basedCGTCMSMedicare Part DMedicaid

FORM 24CON 100SPEC 72REG 73

AcceptingComprehensive PBM

3 offices · 0 certs

Express Scripts

Pharmacy Benefit Manager · St. Louis, MO, USA

100PBM

National formularySpecialty formularyValue-basedOncology

Value-basedCGTCMSMedicare Part DMedicaid

FORM 24CON 100SPEC 72REG 73

AcceptingComprehensive PBM

3 offices · 0 certs

OptumRx

Pharmacy Benefit Manager · Irvine, CA, USA

100PBM

National formularySpecialty formularyValue-basedOncology

Value-basedCGTCMSMedicare Part DMedicaid

FORM 24CON 100SPEC 72REG 68

AcceptingComprehensive PBM

3 offices · 0 certs

Prime

Prime Therapeutics

Pharmacy Benefit Manager · Eagan, MN, USA

98PBM

National formularySpecialty formularyValue-basedOncology

Value-basedCMSMedicare Part DMedicaid

FORM 24CON 75SPEC 50REG 59

AcceptingComprehensive PBM

2 offices · 0 certs

MedImpact Healthcare Systems

MedImpact Healthcare Systems

Pharmacy Benefit Manager · San Diego, CA, USA

90PBM

National formularySpecialty formularyOncologyAdherence

CMSMedicare Part DMedicaid

FORM 24CON 50SPEC 30REG 64

AcceptingComprehensive PBM

2 offices · 0 certs

Ping An Healthcare Technology

Health Plan Pharmacy Administrator · Shenzhen, China

72PBM

National formularySpecialty formularyOncologyAdherence

NMPACMS

FORM 12CON 50SPEC 30REG 33

AcceptingBroad capability

2 offices · 0 certs

IQVIA Market Access

Market Access Consultant · London, United Kingdom

62PBM

National formularySpecialty formularyValue-basedOncology

Value-basedCGTCMSMedicare Part DHIPAA

FORM 16CON 100SPEC 64REG 85

AcceptingBroad capability

4 offices · 0 certs

CHIRA

China Healthcare Insurance Research Association Services

Formulary Management Organization · Beijing, China

60PBM

National formularyOncology

NMPA

FORM 12CON 50SPEC 10REG 22

AcceptingBroad capability

1 offices · 0 certs

Specialty Pharmacy Benefit Manager · Zuchwil, Switzerland

60PBM

Specialty formularyValue-basedOncologyRare disease

Value-basedCGTGDPRFDACMS

FORM 12CON 56SPEC 72REG 32

AcceptingBroad capability

2 offices · 0 certs

Alliance Healthcare Services

Specialty Pharmacy Benefit Manager · Chessington, United Kingdom

57PBM

Specialty formularyValue-basedOncologyRare disease

Value-basedGDPRCMS

FORM 12CON 56SPEC 50REG 27

AcceptingEstablished

2 offices · 0 certs

Cegedim

Reimbursement Service Provider · Boulogne-Billancourt, France

57PBM

National formularyAdherence

GDPRCMS

FORM 8CON 50SPEC 10REG 27

AcceptingEstablished

2 offices · 0 certs

JMDC Inc.

Reimbursement Service Provider · Tokyo, Japan

57PBM

National formularyValue-basedOncologyAdherence

Value-basedPMDACMS

FORM 12CON 75SPEC 20REG 33

AcceptingEstablished

2 offices · 0 certs

Market Access Consultant · Tokyo, Japan

57PBM

National formularySpecialty formularyValue-basedOncology

Value-basedPMDA

FORM 12CON 56SPEC 40REG 27

AcceptingEstablished

1 offices · 0 certs

JD Health

Health Plan Pharmacy Administrator · Beijing, China

56PBM

National formularySpecialty formularyOncologyAdherence

NMPA

FORM 12CON 50SPEC 30REG 22

AcceptingEstablished

2 offices · 0 certs

Nihon Chouzai Healthcare Solutions

Specialty Pharmacy Benefit Manager · Tokyo, Japan

55PBM

Specialty formularyOncologyRare diseaseAdherence

PMDA

FORM 8CON 41SPEC 50REG 22

AcceptingEstablished

2 offices · 0 certs

SOMPO Healthcare

Health Plan Pharmacy Administrator · Tokyo, Japan

55PBM

National formularyAdherence

PMDA

FORM 8CON 41SPEC 10REG 28

AcceptingEstablished

1 offices · 0 certs

PHOENIX Healthcare Services

PHOENIX Healthcare Services

Reimbursement Service Provider · Mannheim, Germany

52PBM

National formularySpecialty formularyOncologyAdherence

GDPRCMSFDA

FORM 12CON 50SPEC 30REG 38

AcceptingEstablished

3 offices · 0 certs

Medipal Holdings Healthcare Services

Medipal Holdings Healthcare Services

Reimbursement Service Provider · Tokyo, Japan

51PBM

National formularySpecialty formularyOncologyAdherence

PMDA

FORM 12CON 50SPEC 30REG 22

AcceptingEstablished

2 offices · 0 certs

AliHealth

Health Plan Pharmacy Administrator · Hangzhou, China

50PBM

National formularyOncologyAdherencePatient support

NMPA

FORM 8CON 50SPEC 30REG 22

AcceptingEstablished

2 offices · 0 certs

WeDoctor

Reimbursement Service Provider · Hangzhou, China

44PBM

National formularyAdherence

NMPA

FORM 8CON 41SPEC 10REG 22

AcceptingEstablished

1 offices · 0 certs