AI PBM Comparison Tool

Judi Health (formerly Capital Rx) is a technology-led, fully transparent PBM that rebranded in July 2026. Its JUDI platform provides real-time drug cost visibility, 100% rebate pass-through, and employer-configurable clinical management. With 5M+ covered lives following health-system partnerships, Judi Health is one of the fastest-growing transparent PBMs. Strong fit for self-funded employers prioritizing data access, audit rights, and biosimilar strategy.

Disclosed Rx is a fully transparent pass-through PBM whose name captures its core promise: complete cost disclosure. Charges admin fee only with 100% rebate pass-through and no spread pricing. Ideal for small to mid-market self-insured employers.

Rightway PBM offers a fully transparent pass-through model with industry-leading 30-day termination notice and no auto-renewal. Strong employer portal and proactive clinical navigation. No owned specialty pharmacy but supports carve-out to independent specialty.

Navitus Health Solutions is a fully transparent, pass-through PBM founded by SSM Health and Costco. Charges admin fee only with 100% rebate pass-through and no spread pricing. Its GLP-1 Pathways program (2026) provides structured clinical management for GLP-1 agonists with outcomes tracking and employer reporting. With ~7M covered lives, Navitus is one of the largest transparent PBMs. Best fit for self-insured employers 500+ lives seeking proven transparency with strong clinical management.

SmithRx is a technology-first transparent PBM serving self-insured employers. Its Drug Pathways Engine (launched 2026) automates step therapy, prior authorization, and formulary exception management based on employer-defined clinical criteria — reducing administrative burden while maintaining full employer control. Offers 100% rebate pass-through, no spread pricing, and strong analytics. Best fit for mid-market employers (100–5,000 lives) seeking transparent PBM with modern clinical automation.

Veracity Rx is a transparent pass-through PBM whose name reflects its core value proposition: complete honesty about drug costs and fees. With 100% rebate pass-through, no spread pricing, and strong audit rights, Veracity Rx is built for self-insured employers who want to eliminate hidden PBM revenue. A strong choice for employers and advisors committed to full pharmacy cost transparency.

Prescryptive Health is a technology-first transparent PBM that gives employers real-time drug pricing and full data ownership. With 100% rebate pass-through and an open data architecture, Prescryptive eliminates data lock-in and hidden fees. Best suited for self-insured employers who want a modern, technology-driven pharmacy benefit with complete cost transparency.

Ventegra is a transparent pass-through PBM serving self-insured employers who want full cost visibility and employer-aligned incentives. With 100% rebate pass-through, no spread pricing, and strong audit rights, Ventegra eliminates the hidden revenue streams that inflate costs at traditional PBMs. A strong choice for mid-market to large employers building a transparent pharmacy benefit.

VerusRx is a transparent pass-through PBM designed for self-insured employers who want to see exactly what they pay for every drug claim. With 100% rebate pass-through and strong audit rights, VerusRx eliminates the hidden revenue streams that inflate costs at traditional PBMs. A strong choice for mid-market employers building a transparent, employer-aligned benefit stack.

Drexi is a transparent, pass-through PBM built for self-insured employers who want full cost visibility without the conflicts of the Big 3. With a flat admin fee and 100% rebate pass-through, Drexi eliminates spread pricing and hidden revenue streams. Best suited for mid-market employers prioritizing transparency and audit rights over maximum rebate scale.

Abarca Health is a subsidiary of Healthcare Revolution Partners (HRP), a health system-backed entity focused on transparent pharmacy benefits. Its Darwin platform provides real-time drug cost visibility, employer-configurable clinical management, and 100% rebate pass-through. Serves health plans, self-insured employers, and government programs with ~3M covered lives. HRP ownership provides clinical depth and health system alignment. Best fit for employers and health plans seeking transparent PBM with health system backing.

Clear Rx is a transparent pass-through PBM built for self-insured employers who want simple, auditable pharmacy benefits. With 100% rebate pass-through and no spread pricing, Clear Rx delivers full cost visibility without the complexity of traditional PBM models. A strong choice for mid-market employers building a transparent, employer-aligned benefit stack.

ProcareRx is a pass-through PBM serving small to mid-market self-insured employers who want transparent pharmacy benefits without the complexity of larger platforms. With a single admin fee and 100% rebate pass-through, ProcareRx offers a straightforward alternative to traditional PBMs. Best suited for employers prioritizing simplicity and transparency over maximum scale.

Benecard PBF is a transparent pass-through PBM with strong expertise serving unions and Taft-Hartley funds. Charges admin fee only with 100% rebate pass-through and no spread pricing. Solid choice for labor organizations and self-insured employers prioritizing transparency.

Serve You Rx is a pass-through PBM with an owned mail-order pharmacy, offering self-insured employers transparent pharmacy benefits with strong customer service. With 100% rebate pass-through and no spread pricing, Serve You Rx provides a straightforward alternative to traditional PBMs. The owned mail-order pharmacy adds convenience while maintaining transparent pricing.

RxElite is a pass-through PBM serving small to mid-market self-insured employers who want transparent pharmacy benefits with strong customer service. With 100% rebate pass-through and no spread pricing, RxElite provides a straightforward alternative to traditional PBMs. Best suited for employers prioritizing transparency and service quality.

RxPreferred Benefits is a transparent pass-through PBM with a broker-friendly model and competitive pricing for small to mid-market self-insured employers. 100% rebate pass-through and no spread pricing. Strong broker relationships drive distribution.

Pharmacy Benefit Dimensions (PBD) is a transparent pass-through PBM serving small to mid-market self-insured employers. 100% rebate pass-through and no spread pricing at competitive PEPM rates. Solid choice for cost-sensitive employers prioritizing transparency.

AffirmedRx describes its business as pharmacy benefit management focused on transparency, patient-centric care, and innovative pharmacy solutions. Its public materials support a PBM category position; employers should confirm the precise fee structure, rebate treatment, audit rights, specialty arrangements, and performance commitments in the RFP and agreement.

MedImpact Healthcare Systems is an independent PBM (not carrier-owned) with strong health plan experience and international capabilities. Offers pass-through pricing option. Independence from carriers is a key differentiator for employers wanting unbiased PBM management.

Liviniti describes itself as a PBM serving employers and health systems through a transparent, pass-through model. Its public materials state that its PBM revenue is a fully disclosed administrative fee and that rebates and discounts are passed back to clients. Employers should still confirm proposal-specific fees, audit rights, network terms, specialty arrangements, and guarantees in the RFP and agreement.

Maxor National Pharmacy Services is an independent PBM with specialty pharmacy capabilities and strong correctional health expertise. Offers pass-through pricing option. Independence from carriers and specialty capabilities make it a solid mid-tier option.

TrueScripts is a pharmacist-founded independent PBM with transparent pass-through positioning, no-spread pricing, and direct rebate pass-through to clients. Its service orientation and employer focus make it well-suited for small to mid-market self-funded groups. Employers should verify specialty sourcing depth, negotiate explicit audit rights, and confirm rebate definition scope in the contract.

WellDyneRx is an independent PBM with mail order capabilities and pass-through pricing option. Independence from carriers and competitive pricing make it a solid mid-tier option for cost-sensitive self-insured employers.

Script Care is an independent PBM with workers compensation expertise and mail order capabilities. Offers pass-through pricing option. Strong choice for employers with workers compensation pharmacy needs alongside traditional group health pharmacy management.

EmpiRx Health is a clinically driven PBM with a pharmacist-led model and strong utilization management focus. Its specialty cost-containment programs and outcomes orientation differentiate it from traditional PBMs. However, the exact financial model, rebate definitions, and audit rights all require RFP verification — the value-based positioning does not automatically mean pass-through pricing.

ProAct is an employee-owned independent PBM offering high-touch service, custom plan design, and integrated ProAct Pharmacy Services mail and specialty. Its employee-owned structure and therapeutic alternatives programs differentiate it from investor-owned competitors. All financial terms require RFP verification — employers should negotiate explicit pricing transparency, rebate definitions, and audit rights.

VytlOne (formerly MaxorPlus) is an independent PBM with meaningful scale, integrated specialty and rare disease capabilities, and strong 340B health-system expertise. Its independence from national insurers reduces conflict-of-interest risk. Employers should verify the brand transition contracting entity, negotiate explicit pricing and rebate definitions, and secure audit rights in the contract.

Elixir Insurance (formerly Restat) is a mid-tier PBM subsidiary of Rite Aid. Offers hybrid pricing with pass-through option available. Rite Aid financial challenges create contract continuity risk that employers should address explicitly in contract terms.

Vivid Clear Rx is a Hy-Vee-owned employer-focused PBM with pass-through positioning, Cost Plus Drugs integration, and a Midwest-friendly footprint. Its VCRx Premier formulary and employer orientation are genuine strengths for regional groups. Employers should verify Hy-Vee retail affiliation economics, negotiate explicit rebate definitions and audit rights, and confirm specialty depth for their needs.

Abarca Health and LucyRx announced a strategic combination in June 2026, creating a modern technology-led PBM with configurability and specialty management capabilities. The combination status and integration timeline must be verified before contracting. All financial terms — pricing, rebates, audit rights — require RFP verification. Best suited for employers comfortable with emerging relationships.

PerformRx is a longstanding managed-care PBM affiliated with AmeriHealth Caritas, offering deep customization and clinical management capabilities. It is primarily positioned for health plans and public programs, with select employer arrangements. All financial terms require RFP verification. Employers should verify direct access, negotiate audit rights, and understand the AmeriHealth Caritas affiliation implications.

Prime Therapeutics is owned by 18 Blue Cross Blue Shield plans and serves BCBS-affiliated employers. Offers strong BCBS network integration and specialty capabilities through Specialty Connect, but operates on traditional model with BCBS intermediary layer limiting direct employer transparency.

CarelonRx is the PBM arm of Elevance Health, offering integrated medical and pharmacy data capabilities and multiple formulary options. It is primarily positioned for employers in Elevance-affiliated health plans. All financial terms require RFP verification. Employers should verify direct access, understand vertical integration implications, and negotiate specialty carve-out and audit rights explicitly.

Rx Solutions is the PBM arm of Highmark Health, primarily serving Highmark-affiliated health plans and employers in the Mid-Atlantic region. Strong Highmark network integration, but operates on traditional spread-pricing model with Highmark intermediary layer.

EnvisionRx (now Rite Aid Health Solutions) is a PBM subsidiary of Rite Aid with Medicare Part D expertise and retail network access. Rite Aid financial challenges create significant contract continuity risk that employers must address explicitly. Traditional spread-pricing model limits transparency.

Humana Pharmacy Solutions is the PBM arm of Humana, primarily serving Humana-affiliated health plans and employers. Strong Medicare Part D expertise and integrated health programs, but operates on traditional spread-pricing model with Humana intermediary layer.

Express Scripts (now Evernorth under Cigna) is the largest PBM by covered lives. Offers broad network and deep specialty capabilities through Accredo, but operates on a traditional spread-pricing and rebate-retention model that limits employer cost transparency.

OptumRx is the PBM arm of UnitedHealth Group, offering deep integration with UHC health plans and Optum clinical programs. Strong analytics and specialty capabilities, but operates on traditional model with inherent data-sharing concerns for non-UHC employers.

CVS Caremark is the second-largest PBM, deeply integrated with CVS Health retail pharmacies, CVS Specialty, MinuteClinic, and Aetna insurance. Offers broad capabilities but operates on traditional spread-pricing model with inherent conflicts from owned retail network.

Magellan Rx Management is a specialty-focused PBM acquired by Prime Therapeutics in December 2022. Its prior Centene/Magellan Health ownership should not be used in current independence analysis. Comparative ratings are withheld pending review of current ownership, operating model, and employer-facing terms.