What Sav-Rx does

Sav-Rx, operating through its legal entity A & A Services, LLC, is an independent, second-generation family-owned Medication Benefits Manager (PBM) headquartered at 224 North Park Avenue, Fremont, Nebraska, with a secondary operations center in Chicago. Founded by Jim Barta in 1969 as A&A Drug and rebranded to Sav-Rx Prescription Services in 1987, the company is the only fully unionized PBM in the United States and is endorsed for over 20 years by IBEW, NECA, BAC and the Iron Workers. Following its February 2026 acquisition by MedImpact Healthcare Systems, Sav-Rx continues to operate independently under existing leadership (CEO Christy Piti, Director of Finance Collin Piti).

The company's core platform is a vertically integrated pharmacy benefits stack consisting of a wholly owned retail pharmacy network of more than 74,000 locations (including 18,000+ independents), a centralized mail-order facility in Fremont, Nebraska, and a specialty pharmacy for biotech injectables, infusions and advanced oral drugs. Supporting capabilities include clinical management (prior authorization, step therapy, biosimilar optimization, fraud and abuse prevention, an opioid prior authorization program in place since 2001), a Remote Patient Monitoring program with connected peripheral devices, and the MyPath weight management program launched in 2026. Customer-facing infrastructure includes a unified login (Sav-Rx Passport), Patient, Admin, Provider and CAA portals, and 24/7/365 live unionized U.S.-based customer service.

Sav-Rx serves more than 1,000 clients covering more than 10 million American workers and their families, predominantly union Health and Welfare Funds and self-funded employers/municipalities. The company operates two transparent pricing models: a 100% Transparent Pass-Through Plan that bills a flat administrative and clinical fee, prices drugs at NADAC at both retail and mail, and passes 100% of manufacturer revenue to plan sponsors; and a 100% Transparent Traditional Guaranteed Rate Plan benchmarked to Medi-Span's AWP with disclosed spread. A-S Medication Dispensing Solutions, acquired in 2009, extends distribution into physician and clinic point-of-care dispensing. The company reports clients have incurred 44% less pharmaceutical spend than the market average since 2015 and that 99% of clients have been with Sav-Rx for more than 20 years.

Name

Sav-Rx

Legal name

A & A Services, LLC

Website

https://savrx.com

Company type

Private

Founded year

1968

Operating status

Acquired

Headcount range

251–500 employees

Short description

Sav-Rx is an independent, unionized Medication Benefits Manager serving more than 1,000 clients and 10 million American workers and their families, with a vertically integrated platform spanning a 74,000+ pharmacy retail network, mail-order, specialty pharmacy, and transparent pass-through pricing.

Ownership category

akta.pro rank

Product category

Pharmacy Benefit Management

NAICS

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

SIC

Insurance Agents, Brokers & Service (6411), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Pharmacy Benefit Management (PBM) & Formulary Management IT (HLACAKAD)

akta.pro secondary industries

Specialty Pharmacy Benefit Management (Specialty PBM) (HLAEAKAE), PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL)

Keywords

• Pharmacy benefit management
• Prescription drug benefits
• Union health plans
• Mail order pharmacy
• Specialty pharmacy services

Headquarters

HQ city

Fremont

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Supply Chain, Technology or R&D, Infrastructure, Marketing or Sales

Revenue model

1. Pharmacy Benefit Management Services: Sav-Rx generates revenue through PBM administrative fees, clinical program fees, and spread on drug acquisition costs. The company offers two financial models: (1) 100% Transparent Pass-Through Plan with fixed flat administrative and clinical program fees, drug pricing at NADAC, and 100% of manufacturer revenue passed through to plans; (2) 100% Transparent Traditional Guaranteed Rate Plan utilizing AWP benchmarks with disclosed spread and contractually defined retention.
2. Mail Order Pharmacy Services: Revenue from dispensing prescriptions through wholly owned mail order pharmacy facility in Fremont, Nebraska.
3. Specialty Pharmacy Services: Revenue from specialty pharmaceutical management including biotech injectables, infusions, and advanced oral drugs.
4. Physician Dispensing (A-S Medications): Revenue from affiliate company A-S Medications providing physician and clinic dispensing solutions, the largest provider in the nation serving hundreds of thousands of patients weekly.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels5 records

Core offering

Sav-Rx is a Medication Benefits Manager (PBM) that administers prescription drug benefit plans for union Health and Welfare Funds, organized labor plans, self-funded employers, and municipalities. Its core offering centers on transparent PBM administration, supported by a vertically integrated platform that includes a 74,000+ retail pharmacy network, a wholly owned mail order pharmacy in Fremont, Nebraska, and a specialty pharmacy for biotech injectables, infusions, and advanced oral drugs. The company also delivers clinical management programs, 24/7 live customer service, and member-facing tools such as the MyPath Weight Loss Program and Remote Patient Monitoring.

Product overview

Sav-Rx is an independent, second-generation family-owned Medication Benefits Manager (MBM) headquartered in Fremont, Nebraska, serving over 1,000 clients representing millions of American workers and their families, particularly union Health and Welfare Funds. The company offers a comprehensive, vertically integrated medication benefits management platform that includes: (1) a wholly owned retail network of over 74,000 pharmacies, (2) an integrated mail order pharmacy in Fremont, Nebraska, and (3) a specialty pharmacy for biotech injectables, infusions, and advanced oral drugs. Supporting these core pharmacy services are account management, project management, 24/7 live customer service, clinical programs (prior authorization, step therapy, biosimilar optimization), Remote Patient Monitoring, and MyPath weight loss program. Sav-Rx differentiates through radical transparency, offering both 100% Transparent Pass-Through Plans (using NADAC pricing) and 100% Transparent Traditional Guaranteed Rate Plans (using AWP/Medi-Span). The company also operates A-S Medications, the nation's largest physician dispensing solution provider. Sav-Rx recently joined MedImpact (2026), but continues to operate independently under its existing leadership and service model.

Differentiator

Problem solved

Functional benefit

Products and services

• Sav-Rx Medication Benefits Management (Core PBM Platform) Core pharmacy benefit management platform providing claims adjudication, formulary management, and benefit administration for union Health and Welfare Funds, plan sponsors, and self-funded plans with an emphasis on transparent contracting and alignment with client fiduciary interests.
• Sav-Rx Retail Pharmacy Network Wholly owned network of over 74,000 retail pharmacies across the United States, including all major chains and over 18,000 independent pharmacy locations, providing members with broad access to fill prescriptions.
• Sav-Rx Mail Order Pharmacy Wholly owned and fully integrated mail order pharmacy facility centrally located in Fremont, Nebraska, enabling prescription drug delivery to patients nationwide.
• Sav-Rx Specialty Pharmacy Specialty pharmacy providing management of specialty pharmaceuticals including biotech injectables, infusions, and advanced oral drugs, staffed by licensed clinical pharmacists who coordinate limited-distribution specialty medications through dispensing partners.
• 100% Transparent Pass-Through Plan Fixed flat administrative and clinical program fee with drug pricing at NADAC at both mail and retail. 100% of every dollar from drug manufacturers, not just rebates, is passed through to the plan.
• 100% Transparent Traditional Guaranteed Rate Plan Fully transparent traditional financial model using Medi-Span's AWP as the benchmark drug cost, guaranteeing a percent savings off benchmark with full disclosure of all sources of manufacturer revenues and pass-through of the remainder to the plan.
• Clinical Programs

Quantifiable outcome

• 44% less pharmaceutical spend than market average since 2015
• +6 more outcomes

Named customers10 records

Segments5 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

Feature7 records

Partnerships

One partnership is on record.

• MedImpact Healthcare SystemscoreOthers · 2 February 2026MedImpact Healthcare Systems completed acquisition of Sav-Rx in February 2026. Sav-Rx continues to operate independently under its existing leadership and service model. The transaction expands MedImpact's scale and expertise in pharmacy benefits management while maintaining Sav-Rx's brand and approach.

Scale indicators8 records

Recent moves7 records

Expansion highlights5 records

Direct peers

• MedImpact Healthcare Systems: Direct parent and PBM peer. MedImpact is a transparent, pass-through PBM serving health plans, employers, and government programs; acquired Sav-Rx in February 2026 and operates it as an independent subsidiary. Nearly identical business model and target customers.
• Navitus Health Solutions: Pass-through, transparent PBM serving health plans, labor unions, and self-funded employers. Closest direct competitor to Sav-Rx in business model (NADAC-based pricing, no spread pricing) and target customer base (including organized labor and Taft-Hartley funds).
• Elixir Pharmacy: Independent pass-through PBM with retail and mail-order pharmacy operations, serving health plans and employers. Directly comparable to Sav-Rx in transparent-pricing positioning and vertically integrated pharmacy services.
• Amber Specialty Pharmacy: Specialty pharmacy and PBM hybrid serving patients with complex conditions, providing specialty drug management and infusion services. Comparable to Sav-Rx's specialty pharmacy operations and clinical management for high-cost therapies.

Emerging players

• Capital Rx: Technology-forward PBM with a transparent, pass-through pricing model and proprietary claims-processing platform (Judi). Targets self-funded employers and unions with a similar anti-spread narrative to Sav-Rx's positioning.
• SmithRx: Transparent, pass-through PBM focused on self-funded employers. Comparable to Sav-Rx in pricing transparency and clinical program emphasis, though newer and less vertically integrated in pharmacy operations.
• CerpassRx: Independent, transparent PBM focused on self-funded employers and labor unions, with pass-through pricing and clinical management programs. Closely comparable niche positioning to Sav-Rx in the union and employer segments.

Broad incumbents

• OptumRx: Largest U.S. PBM (UnitedHealth Group subsidiary) serving national employers, health plans, and government programs. Sets the industry benchmark against which Sav-Rx's transparent model differentiates, and represents the principal incumbent competitor.
• CVS Caremark: Top-three U.S. PBM vertically integrated within CVS Health, combining pharmacy benefit management with retail pharmacy and specialty operations. Comparable vertical integration model but at vastly larger scale.
• Express Scripts: Top-three U.S. PBM owned by Cigna, serving national employer and health plan clients with full-service PBM, specialty, and mail-order capabilities. Competes for the same self-funded plan and large employer RFPs as Sav-Rx.

Market position

Strengths3 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Subsidiaries1 record

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 Sav-Rx