About Us

Pharmcentrix Health was founded in 2018 by a cohort of pharmacists that understood the issues payors and providers faced with current PBM practices. Healthcare spending in the U.S is growing at an alarmingly rate. The Centers for Medicare and Medicaid (CMS) released National Health Expenditure (NHE) Data for 2016 and revealed a 4.3% growth to $3.3 trillion dollars. NHE predicts spending to increase to an average rate of 5.5% and to reach $5.7 trillion dollars by 2026. Much scrutiny has been placed towards drug manufacturers and more specifically on PBM’s as little to no regulation exists for this industry.

A PBM’s primary function is to handle the processing of prescription claims but has since morphed into a role where they negotiate pricing due to the market share they represent. This evolution created an opportunity for PBM’s to make a significant amount of revenue utilizing various strategies such as negotiating discounts from drug manufacturers and drugstores, steering plan members from brand to generic drugs and or moving patients from retail to mail order stores. In doing so, PBM’s secured fixed discounts on medications for health plans from drug manufacturers. However, drug manufacturers also provided substantial rebates to PBM’s for shifting market share to one manufacturer generic or brand by excluding or altering medication tiers on formularies. These savings or “rebates” are not entirely passed through to the client and often retained by the PBM. This system has created numerous conflicts of interests and possibly compromised healthcare for millions of Americans. There has never been a need for more clarity.

Here at Pharmcentrix Health, we customize formularies that are fair, unique and efficacious, thus meeting the needs of payors and patients. We provide full disclosure of pricing and have set fees for our respective services. If the price of a medication changes, we guarantee our pricing will reflect this. We have developed an innovative technology based infrastructure capable of supporting all clinical and informatic needs in addition to a robust quality assurance process that places an emphasis on compliance. We offer our members the option to enroll in mail order service, but do not mandate it. Our focus is simple, creating a fair market that is sustainable by providing value, transparency and personalized health services centered around our clients, partners and patients.

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