SmithRx
SmithRx is a modern pharmacy benefit manager serving 5,000+ self-insured employers across 36 states via a 100% pass-through pricing model with flat PMPM admin fees. The proprietary Drug Pathways Engine and Connect 360 programs deliver 20%+ drug-cost savings versus legacy PBMs.
- Company typePrivate
- Founded2016
- HeadquartersSan Francisco, United States
- Headcount501–1,000
- GTM typeB2B
- OfferingServices
What SmithRx does
SmithRx is a privately held, modern pharmacy benefit manager (PBM) founded in 2016 and headquartered in San Francisco, with additional engineering operations in Lehi, UT, and a Plano, TX office. The company serves more than 5,000 self-insured employer clients across 36 states, delivering pharmacy benefits to hundreds of thousands of members through an 85,000+ pharmacy network. SmithRx sells primarily through benefits brokers and consultants and competes directly against vertically integrated legacy PBMs that control approximately 80% of the U.S. prescription drug market.
The company's core product is the SmithRx Modern PBM Platform, which operates on a 100% pass-through pricing model: clients pay exactly what pharmacies are reimbursed, plus a flat per-member-per-month (PMPM) administrative fee that is fully decoupled from drug spend. SmithRx retains no rebates, charges no spread pricing, and has no ownership interest in pharmacies or manufacturers. The platform is differentiated by the proprietary Drug Pathways Engine, which continuously identifies lowest-net-cost medication pathways, and by the Connect 360 cost-containment suite, which activates coupons, manufacturer assistance programs, and alternative sourcing (including a partnership with Mark Cuban Cost Plus Drugs). Average PMPM cost is more than 20% below legacy PBM benchmarks, with case-study clients reporting PMPM as low as $39 versus the $112 industry average.
SmithRx generates revenue exclusively through fixed monthly administrative fees per member. Its go-to-market is enterprise field sales supported by a broker channel (Brown & Brown, Hotchkiss Insurance, Intrepid Benefits, The Daniel & Henry Company) and content-led demand generation via the SmithRx blog, Full Disclosure webinar series, and PBM Evaluation Guide. The company has raised approximately $80 million across multiple venture rounds, with Venrock leading both the $20M Series B (March 2022) and $60M Series C (January 2024). SmithRx is among the first 25 PBMs to earn URAC Pharmacy Benefit Management Accreditation (valid through February 2029) and is a founding member of Transparency-Rx, a federal PBM reform coalition.
SmithRx firmographics
Firmographics- Name
- SmithRx
- Legal name
- Smith Health, Inc.
- Website
- https://smithrx.com
- Company type
- Private
- Founded year
- 2016
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- SmithRx is a modern pharmacy benefit manager serving 5,000+ self-insured employers across 36 states via a 100% pass-through pricing model with flat PMPM admin fees. The proprietary Drug Pathways Engine and Connect 360 programs deliver 20%+ drug-cost savings versus legacy PBMs.
- Ownership category
- akta.pro rank
SmithRx industry classification
Industry- Product category
- Pharmacy Benefit Management
- NAICS
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)
- SIC
- Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Pharmacy Benefit Management (PBM) & Pharmacy Network Administration (HLAFALAI)
- akta.pro secondary industries
- Manufacturer Contracting, Rebates & Revenue Management (HLAEAKAD), PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL), Formulary Management & Clinical Pharmacy Programs (HLAEAKAA), Copay Assistance, Patient Support & Affordability Programs (HLAEAKAI)
Keywords
Where SmithRx is headquartered
LocationHeadquarters
- HQ city
- San Francisco
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
SmithRx business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure
Revenue model
- Administrative Fees (PMPM): SmithRx charges a flat administrative fee per member per month (PMPM) as its primary revenue source. This fee structure is decoupled from drug spend, ensuring the company's incentives are aligned with reducing drug costs for clients rather than maximizing medication spend. Average PMPM cost for clients is more than 20% below industry averages.
- Pass-Through Drug Revenue: 100% of rebates and discounts from manufacturers are passed through to plan sponsors. SmithRx does not take economics from the supply chain, does not retain rebates, and does not engage in spread pricing. The company makes no revenue from drug ingredient costs.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Flat Administrative Fee Model |
| Other | Monthly | Pass-Through Pricing |
| Other | Monthly | Platform-Based Cost Model |
Go-to-market motion3 records
Distribution channels3 records
Marketing channels6 records
SmithRx product offering
Product offeringCore offering
SmithRx is a modern pharmacy benefit manager (PBM) that delivers 100% pass-through pharmacy benefits to self-insured employers, eliminating spread pricing and rebate retention. The company charges a flat per-member-per-month (PMPM) administrative fee decoupled from drug spend, while passing all manufacturer rebates and discounts back to plan sponsors. Its platform combines the proprietary Drug Pathways Engine, Connect 360 cost-containment programs, and transparent claims-level reporting to achieve 20%+ savings versus legacy PBMs.
Product overview
SmithRx offers a modern pharmacy benefit management (PBM) platform built on radical transparency and fiduciary alignment. The core offering is the SmithRx Modern PBM Platform, which operates on a 100% pass-through model delivering actual contracted pharmacy rates without spread pricing or hidden fees. This platform is enhanced by the Connect 360 cost-containment module (covering coupons, manufacturer savings, and assistance programs), the proprietary Drug Pathways Engine for savings optimization, and the Find My Meds member cost-comparison tool. The architecture decouples drug ingredient costs from dispensing fees to surface true market pricing to employers, with an average PMPM cost more than 20% below industry averages.
Differentiator
Problem solved
Functional benefit
Products and services
- SmithRx Modern PBM Platform A radically transparent pharmacy benefit management platform providing 100% pass-through pricing, fiduciary-aligned services, and technology-powered member experience for self-insured employers. The platform delivers real-time cost visibility, claims-level data access, audit rights, and white-glove service, with PMPM costs averaging 20%+ below industry averages.
- Connect 360 A suite of cost-containment programs including coupon application, manufacturers' savings programs, patient assistance programs, and drug company partnerships. Connect 360 identifies lowest-cost medication pathways and provides hands-on member support for enrollment and savings realization, with reported results such as 75% increase in savings between 2022-2024 for Encore Enterprises and 57x ROI within 6 months for AgXplore.
Quantifiable outcome
- 20%+ savings on total drug costs vs legacy PBMs
- +5 more outcomes
Companies that use SmithRx
Customer profileNamed customers6 records
Segments4 records
Ideal customer profiles2 records
SmithRx technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability3 records
Feature6 records
SmithRx partnerships and signals
Strategic signalPartnerships
Six partnerships are on record, tiered core and flagship.
- 9amHealthcorePart of SmithRx's best-in-class partner ecosystem for GLP-1 and weight management programs. 9amHealth specializes in obesity medicine and weight management, helping employers deliver sustainable GLP-1 coverage leveraging manufacturer-approved cash-pay pricing.
- CalibratecorePart of SmithRx's GLP-1 partner ecosystem. Calibrate provides specialized obesity medicine and weight management programs integrated with SmithRx's transparent PBM model to help employers achieve sustainable GLP-1 coverage.
- FlyteHealthcorePart of SmithRx's GLP-1 partner ecosystem offering specialized obesity medicine and weight management services to support employers in delivering sustainable GLP-1 coverage.
- Form HealthcorePart of SmithRx's GLP-1 partner ecosystem providing specialized obesity medicine and weight management programs to help employers deliver clinically appropriate and cost-effective GLP-1 coverage.
- Mark Cuban Cost Plus Drugs CompanycoreThrough partnership with Mark Cuban Cost Plus Drug Company, SmithRx announced $9.5 million in client savings through innovative autoimmune drug sourcing. The partnership leverages Cost Plus Drugs' transparent cost-plus pricing model (manufacturer cost plus 15% markup plus $3 fee). Some employers achieved up to 70% in cost savings.
- Transparency-RxflagshipSmithRx is a founding member of Transparency-Rx, a lobbying coalition advocating for industry reforms targeting prescription drug costs. The coalition pushes for PBM reform and greater transparency in the pharmaceutical supply chain.
Scale indicators10 records
Recent moves6 records
Expansion highlights6 records
SmithRx competitors and assessment
Company assessmentBroad incumbents
- CVS Caremark: CVS Caremark is the largest U.S. PBM and part of CVS Health, controlling a substantial share of the prescription drug market. It represents the incumbent model that transparent PBMs like SmithRx are displacing, with vertically integrated pharmacy and insurance operations.
- OptumRx: OptumRx is the PBM arm of UnitedHealth Group and one of the three dominant legacy PBMs. It represents the vertically integrated incumbent that transparent PBMs like SmithRx compete against for self-insured employer accounts.
- Express Scripts: Express Scripts is one of the three largest U.S. PBMs, owned by Cigna, and represents the legacy PBM model that SmithRx's pass-through positioning is designed to displace. It offers broad formulary management and mail-order pharmacy capabilities.
Others
- Mark Cuban Cost Plus Drug Company: Cost Plus Drugs is a SmithRx partner that disrupts drug pricing through transparent cost-plus markup. It is both a distribution partner for autoimmune drug sourcing and an adjacent industry disruptor aligned with SmithRx's transparency mission.
Emerging players
- AffirmedRx: AffirmedRx is an emerging transparent PBM serving self-insured employers with a 100% pass-through model. As a newer entrant in the same transparency-focused category, it competes for similar employer clients seeking fiduciary-aligned PBM services.
Direct peers
- Liviniti: Liviniti (formerly known as LDI Integrated Pharmacy Services) is a transparent PBM serving self-funded employers with pass-through pricing and customized clinical programs. The companies compete head-to-head for the same self-insured employer segment.
- Capital Rx: Capital Rx is a direct transparent PBM competitor offering a technology-driven, pass-through model with no spread pricing and full rebate pass-through to plan sponsors. Both companies target self-insured employers with claims-level transparency and technology-led cost optimization.
- Navitus Health Solutions: Navitus is a transparent, pass-through PBM serving employer-sponsored and health plan clients. Both companies share the 100% pass-through model with no rebate retention and emphasize client-aligned cost savings versus legacy PBM economics.
- RxBenefits: RxBenefits provides pharmacy benefit management services to mid-market employers primarily through benefits brokers. Like SmithRx, RxBenefits leverages the broker channel and focuses on transparent contracting for self-insured employer plans.
- EmpiRx Health: EmpiRx Health is a transparent PBM offering pass-through pricing and clinical management services to self-insured employers and labor unions. Both companies target the same segment with a similar transparency-focused value proposition.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
SmithRx social profiles
Digital presenceSmithRx compliance and trust
Trust signalCompliance1 record
SmithRx financial estimates
Financial estimateRevenue estimate
Valuation estimate
SmithRx leadership team
Management profileNumber of profiles
Profiles10 records
SmithRx funding detail
Funding detailFunding overview
Funding rounds7 records
Investors11 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
SmithRx M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about SmithRx
What does SmithRx do?
SmithRx is a modern pharmacy benefit manager (PBM) that delivers 100% pass-through pharmacy benefits to self-insured employers, eliminating spread pricing and rebate retention. The company charges a flat per-member-per-month (PMPM) administrative fee decoupled from drug spend, while passing all manufacturer rebates and discounts back to plan sponsors. Its platform combines the proprietary Drug Pathways Engine, Connect 360 cost-containment programs, and transparent claims-level reporting to achieve 20%+ savings versus legacy PBMs.
Is SmithRx a public or private company?
SmithRx is a private company. It is classified as venture growth investor backed and is currently operating.
When was SmithRx founded?
SmithRx was founded in 2016. It employs 501 to 1,000 people.
Where is SmithRx based?
SmithRx is headquartered in San Francisco, United States, in the North America region.
How does SmithRx make money?
Two revenue lines are on record. Administrative Fees (PMPM) is the primary driver. The others are pass-Through Drug Revenue.
Who are SmithRx's main competitors?
Broad incumbents on record are CVS Caremark, OptumRx and Express Scripts. Mark Cuban Cost Plus Drug Company is listed as an others. AffirmedRx is listed as an emerging player. Direct peers are Liviniti, Capital Rx, Navitus Health Solutions, RxBenefits and EmpiRx Health.
Does SmithRx have an API?
No public API is recorded for SmithRx.
What industry is SmithRx in?
SmithRx's product category is Pharmacy Benefit Management. Its primary akta.pro industry code is HLAFALAI, Pharmacy Benefit Management (PBM) & Pharmacy Network Administration, with a secondary code of HLAEAKAD, Manufacturer Contracting, Rebates & Revenue Management. Its NAICS code is 524292 and its SIC code is 6324.