VIVIO Health

What VIVIO Health does

VIVIO Health is a specialty drug management company founded in 2016 and headquartered in the San Francisco Bay Area (Hayward/San Leandro, CA). It serves self-insured employers and health plans with an alternative to traditional Pharmacy Benefit Manager (PBM) arrangements, procuring specialty drugs directly from manufacturers at acquisition cost plus a transparent dispensing fee and dispensing through an in-house specialty pharmacy network. The company positions its model as independent of manufacturer rebate influence, using proprietary clinical evaluation to assign patients to clinically appropriate, lowest-cost therapy options across the specialty drug book.

The product portfolio spans PrecisionCare Drug Management (a specialty carve-out that supplements an incumbent PBM), Total Drug Management, Medical Carve-Out, PrecisionCare One (a full PBM replacement launched in November 2024), and dedicated GLP-1 and HIV therapy programs. VIVIO claims validated savings of 30-50% on total drug spend, 40%+ on specialty, and 50%+ on medical drug spend, with a 7.5x client ROI on its fees. Pricing is a flat Per-Member-Per-Month (PMPM) fee, and the customer base is concentrated in enterprise employers (Werner Enterprises, Dean Foods, CHG Healthcare, Lake County Schools).

The company operates as a Delaware Public Benefit Corporation (since August 2021), is privately held and bootstrapped with no external capital, and has 11-50 employees. Strategic partners include Mark Cuban Cost Plus Drug Company (extending transparent pricing into retail generics) and law firm Frier Levitt (supporting employer PBM audits and disputes). Clinical leadership is supported by a specialty advisory board, and distribution is increasingly routed through benefits consultants such as Aon and Mercer.

Name

VIVIO Health

Legal name

VIVIO Health, Inc.

Website

https://viviohealth.com

Company type

Private

Founded year

2016

Operating status

Operating

Headcount range

11–50 employees

Short description

VIVIO Health is a specialty drug management company that procures specialty medications at acquisition cost plus a transparent dispensing fee, offering self-insured employers and health plans an alternative to traditional rebate-driven PBM arrangements through carve-out and full PBM replacement products.

Ownership category

akta.pro rank

Product category

Specialty Drug Management

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Wholesale-Drugs, Proprietaries & Druggists' Sundries (5122)

akta.pro primary industry

Formulary Management & Clinical Pharmacy Programs (HLAEAKAA)

akta.pro secondary industry

Pharmacovigilance, Drug Safety & Risk Management FSP (HLAGAOAF)

Keywords

• Specialty drug management
• Pharmacy benefit management
• Drug spend optimization
• Clinical drug selection
• Precision drug therapy

Headquarters

HQ city

San Leandro

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales

Revenue model

1. Flat PMPM Fee (Per Member Per Month): VIVIO operates on a flat per-member-per-month (PMPM) fee model, passing all savings directly to Plan Sponsors and members. No DIR fees are charged to participating pharmacies. No rebates, no formulary-driven pricing schemes.
2. Specialty Drug Management Services: VIVIO manages specialty, non-specialty, and medical drug categories, generating savings across all drug spend categories. Savings range from 30-50% for self-funded employers, with specialty carve-out programs delivering 40%+ savings and medical carve-out delivering 50%+ savings.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels6 records

Core offering

VIVIO Health provides drug management services to self-insured employers and health plans as an alternative to traditional Pharmacy Benefit Managers (PBMs). Its PrecisionCare™ platform analyzes clinical trial data and open-market cash pricing to deliver personalized drug therapy reviews across specialty, non-specialty, and medical drug categories. The company is paid a flat per-member-per-month fee and passes all drug spend savings directly to plan sponsors.

Product overview

VIVIO Health is a Public Benefit Corporation offering a suite of drug management products centered on its PrecisionCare™ platform. The core offering includes PrecisionCare Drug Management (Specialty Carve-Out) for self-administered specialty drugs, PrecisionCare Total Drug Management as a full PBM replacement for all prescription drugs, and PrecisionCare Medical Drug Management (Medical Carve-Out) for professionally administered medications. The platform was extended with PrecisionCare One™, which unifies all drug management under an open-market model. Add-on programs include GLP-1 and HIV management modules. All products leverage clinical trial data and market pricing analysis to ensure patients receive the right drug at the right price, with demonstrated savings of 30-50%.

Differentiator

Problem solved

Functional benefit

Products and services

• PrecisionCare Drug Management (Specialty Carve-Out) Management of self-administered specialty drugs focused on the right drug, for the right person, at the right price. Delivers 40%+ savings on specialty drug spend by leveraging open market pricing and personalized clinical review.
• PrecisionCare Total Drug Management Full PBM replacement for all prescription drugs leveraging the Cash Pay marketplace. Delivers 30%+ savings on pharmacy drug spend by managing specialty, non-specialty, and medical drugs through an open market model with no rebate games or formularies.
• PrecisionCare Medical Drug Management (Medical Carve-Out) Medical specialty drug management covering HCPCS codes for professionally administered medications. Delivers 50%+ savings on medical specialty drug spend through clinical review and open market pricing access.
• PrecisionCare One™ Comprehensive open-market drug management platform that extends VIVIO's specialty drug management approach to include all drugs (full PBM replacement). Includes a GLP-1 clinical management program as an integrated component. Built on open-market principles and data-driven clinical models.
• GLP-1 Program (Add-On) Clinically driven GLP-1 program to manage out-of-control spend on diabetes medications. Applies evidence-based clinical review to GLP-1 therapy selection and pricing.
• HIV Program (Add-On) Clinically driven program to manage out-of-control spend on HIV medications, including PEP (post-exposure prophylaxis) and PrEP (pre-exposure prophylaxis). Uses personalized pharmacy review to optimize drug selection and reduce costs.

Quantifiable outcome

• 30-50% savings on total drug spend for self-funded employers
• +5 more outcomes

Named customers5 records

Segments3 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability5 records

Feature6 records

Partnerships

Two partnerships are on record, tiered core.

• Mark Cuban Cost Plus Drug CompanycoreStrategic or Co-development Partner · 18 October 2022VIVIO partnered with Mark Cuban Cost Plus Drug Company (a Public Benefit Corporation) to help employers and health plans access lower-cost specialty drugs. The partnership enables VIVIO patients to purchase specialty medications at significantly reduced prices (e.g., a $3,000/month generic drug sourced for $75 for a 3-month supply). Both companies are Public Benefit Corporations committed to transparency and reducing healthcare costs.
• Frier LevittcoreImplementation/ SI/ Consulting Partner · 1 January 2022VIVIO partnered with Frier Levitt, a life sciences and ERISA law firm, to address fiduciary compliance and PBM litigation risks for employers. The firms co-presented webinars on the J&J ERISA lawsuit and alternative funding programs, combining VIVIO's drug management expertise with Frier Levitt's ERISA legal expertise.

Scale indicators7 records

Recent moves7 records

Expansion highlights6 records

Broad incumbents

• CVS Caremark (CVS Health): CVS Caremark is the largest U.S. PBM and a segment of CVS Health, offering pharmacy benefit management integrated with retail pharmacies, insurance (Aetna), and clinical services. It is the dominant incumbent VIVIO competes against for employer accounts.
• Express Scripts (The Cigna Group): Express Scripts is the second-largest U.S. PBM and a subsidiary of The Cigna Group, integrated with health insurance and specialty pharmacy (Accredo). It is a key incumbent competitor to VIVIO in the employer PBM market.
• OptumRx (UnitedHealth Group): OptumRx is the PBM segment of UnitedHealth Group/Optum, integrated with UnitedHealthcare insurance and Optum's care delivery platform. It is the third major incumbent PBM that VIVIO positions against as part of the Big-3 alternative narrative.

Direct peers

• Navitus Health Solutions: Navitus is a mission-driven, transparent PBM that passes 100% of rebates and discounts to clients, serving health plans, employers, and government programs. It competes directly with VIVIO's no-rebate, transparent pricing model in the self-funded employer market.
• SmithRx: SmithRx is a transparent PBM targeting self-insured employers with pass-through pricing and a technology platform for pharmacy benefit management. It is a direct competitor in the transparent PBM carve-out and replacement market.
• Capital Rx: Capital Rx is a transparent, vertically integrated PBM offering a technology-driven pharmacy benefit administration platform for employers, health plans, and government programs. It is the most directly comparable competitor to VIVIO's open-market, no-rebate approach.
• EmpiRx Health: EmpiRx Health is a clinically-driven PBM focused on outcomes-based pharmacy management for self-insured employers and health plans. It competes with VIVIO's data-driven clinical review and specialty drug management approach.
• CerpassRx: CerpassRx is a transparent, pass-through PBM serving self-funded employers, municipalities, and health plans with customizable pharmacy benefit solutions. It is a direct competitor in the transparent PBM market targeting similar employer segments.
• RxBenefits: RxBenefits is a pharmacy benefit optimizer that partners with benefits brokers to serve mid-market self-funded employers through negotiated PBM contracts. It is comparable to VIVIO in serving self-insured employers via the broker channel, though with a different pricing structure.

Emerging players

• Mark Cuban Cost Plus Drug Company: Mark Cuban Cost Plus Drug Company is a Public Benefit Corporation offering transparent cash-pay prescription drug pricing direct to consumers, with employer partnerships. It is both a VIVIO strategic partner and an emerging competitor in transparent drug pricing.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/viviohealth
• Facebookfacebook.com/viviohealth
• LinkedInlinkedin.com/company/viviohealth

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles24 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about VIVIO Health