Pharmacist assisting a customer. PBMs help manage prescription drug benefits, lowering costs and improving patient outcomes.

For PBMs

Cost Containment &
Clinical Support
Services Designed Specifically for PBMs

Helping PBMs Outpace the Competition

While the 'Big Three' dominate in market share, smaller PBMs lead in innovation.

Visual representation of an 80-20 split. top header 'PBM Market Share Breakdown' 80% 'The Big Three' 20% 'Other PBMs'

ELMCRx empowers small and mid-sized PBMs with a suite of proven clinical and financial
solutions, leading to better service and savings compared to the competition.

Access Our Solutions

Expand Your PBM Services

For PBMs, client success means containing pharmacy benefits costs and limiting exposure to high-cost medications, both specialty and non-specialty. Having a trusted partnership is key at every step of this process, from PBMs and TPAs to brokers, employers, and members.

Advanced Claims Technology

Building a new claims platform is a monumental and disruptive exercise. ELMCRx can help our partners access Capital Rx’s high performing JUDI® system. Whether you are a TPA or Captive looking to create a PBA program for your clients, or a PBM in need of a new platform, ELMCRx can help.

Triangular infographic with three connected circles: a monitor with pills, a document with a heart, and scattered pills. Colors: navy, teal, red.

Advanced Claims Technology

PBM and Clinical Management Solutions

Control pharmacy costs with proven specialty and
non-specialty drug programs, including GLP-1 management, rigorous prior authorizations, and cost-effective alternatives to review and optimize pharmacy spend.

Payment Integrity & Claims Monitoring Solution

Bring contract monitoring solutions to your clients, demonstrating your commitment to transparency and compliance with fiduciary requirements.

Prior Authorization Process Flow

**Alt Text:** Flowchart titled "Process Flow" showing four steps in the medication review process at ELMC Rx: 1. **Claim Approved by PBM and Sent to ELMC Rx** 2. **Pharmacy Tech** pulls review from PBM queue and enters it into ELMC Rx’s processing system. 3. **Specialty Pharmacist** reviews the Prior Authorization (PA) to verify: * PA meets criteria * Medication is on the formulary * Required steps were followed * Medication is FDA approved * Off-label use is clinically documented * Required tests completed * Dosage, weight, body mass, surface area verified * Quantity limits verified * Medication is formulary-approved, less costly, and can be substituted with a clinically equivalent option if appropriate 4. **Pharmacy Tech** enters completed review and documentation back into the PBM system or queue for processing.

ELMCRx has been a leader in Prior Authorization Management since 2017. As an agnostic leader
in this area, we can help you assist your clients in meeting their fiduciary requirements.