CerpassRx
CerpassRx is a U.S. pharmacy benefits manager serving self-insured employers and health plans with PBM administration, clinical programs, and the AI-powered Intelligent Specialty Engine for specialty drug cost management. The company was acquired by LucyRx in October 2025.
- Company typePrivate
- Founded2015
- HeadquartersThe Colony, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What CerpassRx does
CerpassRx is a U.S.-based pharmacy benefit manager (PBM) headquartered in The Colony, Texas, operating as Healthcare Highways Rx, LLC. Founded in 2015 and employing 101-250 people, the company delivers pharmacy benefits administration, clinical programs, and cost-containment services to self-insured employers, health plans, and plan members. Its core product is a PBM platform supported by 15+ clinical and specialty solutions, with add-on modules including a pharmacy discount card, prior authorization services, and the Intelligent Specialty Engine.
The Intelligent Specialty Engine, launched in November 2024 in partnership with Waltz Health, applies AI-powered real-time analytics to specialty drug pricing, pharmacy network costs, and spending data, routing prescriptions to cost-effective pharmacies. Specialty drug spend accounts for over 50% of total drug spend, making this the company's primary technology differentiator. The platform processes structured data and provides decision support to health plans and self-insured employers managing complex specialty therapies.
CerpassRx generates revenue through a combination of recurring administrative fees for PBM services (quote-based, annual contracts negotiated individually by plan size and benefit requirements) and transaction fees from its consumer-facing pharmacy discount card program. The go-to-market is sales-led and partnership-driven, with hands-on implementation and customized benefit design for each client. The company also operates a member services model that places 2 outbound calls for every 5 incoming calls. In July 2025, LucyRx signed a definitive agreement to acquire CerpassRx from Nomi Health, and the deal closed in October 2025, positioning CerpassRx as part of LucyRx's national PBM platform.
CerpassRx firmographics
Firmographics- Name
- CerpassRx
- Legal name
- Healthcare Highways Rx, LLC
- Website
- https://cerpassrx.com
- Company type
- Private
- Founded year
- 2015
- Operating status
- Acquired
- Headcount range
- 11–50 employees
- Short description
- CerpassRx is a U.S. pharmacy benefits manager serving self-insured employers and health plans with PBM administration, clinical programs, and the AI-powered Intelligent Specialty Engine for specialty drug cost management. The company was acquired by LucyRx in October 2025.
- Ownership category
- akta.pro rank
CerpassRx industry classification
Industry- Product category
- Pharmacy Benefits 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
- Specialty Pharmacy Benefit Management (Specialty PBM) (HLAEAKAE)
- akta.pro secondary industries
- Formulary Management & Clinical Pharmacy Programs (HLAEAKAA), Prior Authorization, Utilization Management & Step Therapy (HLAEAKAG), Pharmacy Benefit Management (PBM) & Pharmacy Network Administration (HLAFALAI), Group Pharmacy Benefit (Rx) Coverage & PBM-Integrated Plans (FSAIAFAN)
Keywords
Where CerpassRx is headquartered
LocationHeadquarters
- HQ city
- The Colony
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
CerpassRx business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales
Revenue model
- Pharmacy Benefits Management Services: Core PBM services providing pharmacy benefit administration to self-insured employers and health plans. Revenue generated through a combination of administrative fees and transaction-based pricing for prescription processing.
- Pharmacy Discount Card Program: Consumer-facing prescription discount card program allowing individuals without insurance to access discounted medications at participating pharmacies. Revenue derived from transaction fees negotiated with pharmacies.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Annual | Enterprise PBM Services - Custom quote-based pricing |
Go-to-market motion1 record
Distribution channels3 records
Marketing channels4 records
CerpassRx product offering
Product offeringCore offering
CerpassRx is an independent pharmacy benefits manager (PBM) that administers prescription drug benefits for self-insured employers and health plans. Its offerings include core PBM administration, a consumer pharmacy discount card, prior authorization services, and the AI-powered Intelligent Specialty Engine for specialty drug spend management. The company focuses on high-touch member services, customized clinical programs, and transparent pricing as an alternative to traditional PBM models.
Product overview
CerpassRx operates as a next-generation pharmacy benefits manager (PBM) offering a unified PBM platform with multiple integrated services. The core product is Pharmacy Benefits Management, supplemented by the CerpassRx Pharmacy Discount Card for out-of-pocket prescription savings, Prior Authorization Services for streamlined medication approvals, and the Intelligent Specialty Engine (in partnership with Waltz Health) for AI-powered specialty drug spend optimization. The company positions itself as an alternative to traditional PBM models, emphasizing clinical excellence, cost containment, and high-touch member service with over 15 clinical and specialty solutions.
Differentiator
Problem solved
Functional benefit
Products and services
- Pharmacy Benefits Management (PBM) Core PBM service offering pharmacy benefit administration, clinical programs, and cost-containment strategies focused on member experience and plan savings for self-insured employers and health plans.
- CerpassRx Pharmacy Discount Card A prescription discount card program that provides discounts on medications at participating pharmacies, available as both physical and digital cards for uninsured or underinsured individuals.
- Prior Authorization Services Prior authorization management services integrated into the PBM platform to streamline approval workflows for medications requiring authorization.
- Intelligent Specialty Engine AI-powered platform developed in partnership with Waltz Health that manages specialty drug spend through real-time analytics and competitive pharmacy network routing to cost-effective pharmacies.
Quantifiable outcome
- 94% of employees report CerpassRx is a Great Place to Work
- +2 more outcomes
Companies that use CerpassRx
Customer profileSegments4 records
Ideal customer profiles2 records
CerpassRx technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability3 records
Feature2 records
CerpassRx partnerships and signals
Strategic signalPartnerships
Two partnerships are on record, tiered core.
- LucyRxcoreLucyRx, a next-generation PBM, acquired CerpassRx (a division of Nomi Health) in Q3 2025. The acquisition combined LucyRx's technology-driven clinical model and formulary marketplace with CerpassRx's cost containment expertise and high-touch service approach to form a more comprehensive national PBM platform.
- Waltz HealthcoreCerpassRx partnered with Waltz Health to launch the Intelligent Specialty Engine, an AI-powered platform for specialty drug spend management. The platform utilizes real-time analytics and a competitive pharmacy network to route specialty prescriptions to cost-effective pharmacies, providing data analytics for health plans and self-insured employers facing specialty drug cost pressures.
Scale indicators5 records
Recent moves4 records
Expansion highlights4 records
CerpassRx competitors and assessment
Company assessmentBroad incumbents
- Express Scripts: PBM owned by The Cigna Group, one of the three largest PBMs in the U.S. Provides overlapping PBM, specialty pharmacy, and utilization management services to large employer and health plan customers; primary traditional-PBM incumbent.
- CVS Caremark: PBM arm of CVS Health, one of the "Big Three" PBMs. Overlaps with CerpassRx on pharmacy benefit administration, specialty drug management, and retail pharmacy network; serves as the dominant traditional-PBM competitor CerpassRx explicitly positions against.
- OptumRx: Largest U.S. PBM by prescription volume, part of UnitedHealth Group. Broad incumbent in the same industry with overlapping pharmacy benefit administration, specialty pharmacy, and clinical programs, but operates at vastly greater scale with vertically integrated payer/provider assets.
Direct peers
- SmithRx: Transparent PBM targeting self-insured employers with a technology-first platform. Directly comparable to CerpassRx in customer segment (self-insured employers), value proposition (transparency/lower-cost alternative to traditional PBMs), and product surface area.
- Capital Rx: Technology-driven PBM offering Judi, a unified pharmacy benefit claims processing platform, to employers and health plans. Comparable to CerpassRx in positioning as a tech-forward, transparent alternative to the "Big Three" PBMs and in targeting self-funded plans.
- Navitus Health Solutions: Independent, fully transparent PBM serving health plans, employers, and government programs. Direct peer in transparent-PBM positioning and core PBM service offering, with comparable clinical and specialty management capabilities.
- RxBenefits: PBM focused exclusively on self-insured employers, particularly mid-market employers via broker relationships. Highly comparable customer segment and PBM-services scope to CerpassRx, with emphasis on clinical programs and cost containment.
- LucyRx: Next-generation PBM that acquired CerpassRx in October 2025. Operates a technology-driven clinical model with a formulary marketplace — the closest direct peer given CerpassRx is now a division of LucyRx and shares its national PBM platform strategy.
- EmpiRx Health: Smaller transparent PBM targeting self-funded employer plans with a clinically focused, member-centric model. Comparable in scale, customer segment, and "alternative to traditional PBM" value proposition to CerpassRx.
Emerging players
- Waltz Health: AI-powered specialty drug search and routing platform — CerpassRx's technology partner that built the Intelligent Specialty Engine. Comparable as an emerging AI-driven player focused on specialty drug cost optimization; potentially enabling to other PBMs as well.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks5 records
Key highlights6 records
Customer concentration
CerpassRx social profiles
Digital presenceCerpassRx financial estimates
Financial estimateRevenue estimate
Valuation estimate
CerpassRx leadership team
Management profileNumber of profiles
CerpassRx funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
CerpassRx 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 CerpassRx
What does CerpassRx do?
CerpassRx is an independent pharmacy benefits manager (PBM) that administers prescription drug benefits for self-insured employers and health plans. Its offerings include core PBM administration, a consumer pharmacy discount card, prior authorization services, and the AI-powered Intelligent Specialty Engine for specialty drug spend management. The company focuses on high-touch member services, customized clinical programs, and transparent pricing as an alternative to traditional PBM models.
Is CerpassRx a public or private company?
CerpassRx is a private company. It is classified as corporate owned and is currently acquired.
When was CerpassRx founded?
CerpassRx was founded in 2015. It employs 11 to 50 people.
Where is CerpassRx based?
CerpassRx is headquartered in The Colony, United States, in the North America region.
How does CerpassRx make money?
Two revenue lines are on record. Pharmacy Benefits Management Services are the primary driver. The others are pharmacy Discount Card Program.
Who are CerpassRx's main competitors?
Broad incumbents on record are Express Scripts, CVS Caremark and OptumRx. Direct peers are SmithRx, Capital Rx, Navitus Health Solutions, RxBenefits, LucyRx and EmpiRx Health. Waltz Health is listed as an emerging player.
Does CerpassRx have an API?
No public API is recorded for CerpassRx.
What industry is CerpassRx in?
CerpassRx's product category is Pharmacy Benefits Management. Its primary akta.pro industry code is HLAEAKAE, Specialty Pharmacy Benefit Management (Specialty PBM), with a secondary code of HLAEAKAA, Formulary Management & Clinical Pharmacy Programs. Its NAICS code is 524292 and its SIC code is 6324.