Prescription Care Management

What Prescription Care Management does

Prescription Care Management (PCM), legally Prescription Care Management, LLC and governed under Nevada law, is a private healthcare analytics vendor that provides a cloud-based platform for pharmacy and medical benefit cost containment and validation. The company's core offering is an Interactive Platform that aggregates claims-level pharmacy and medical data, performs PBM contract evaluation and market benchmarking, and runs clinical engagement workflows such as the Alternative Prescription System (A.P.S.) for therapeutic drug substitution. The platform is HITRUST CSF certified and structured into modular components including Data Integration and Monitoring (Rx Analytics, Medical Analytics, File Management), Rx Benefit Plan Services (Market Check, Rx Performance, Rebate Management), Clinical Engagement (PCM Rx Savings, Clinical Review), and a Dynamic Report Builder; a 2025 release added AI-powered natural language querying, self-service analytics, and a self-service PBM RFP module.

PCM serves four primary buyer personas: benefit brokers, pharmacy consultants, third-party administrators (TPAs), and self-insured plan sponsors, with a horizontally segmented approach. Revenue is generated primarily through subscription-based platform access bundled with expert services, supplemented by managed-services-style pharmacy savings programs and professional services for contract audits and validation. Pricing is quote-based with multi-year contracts, and distribution is largely channel-led, with brokers, consultants, and TPAs reselling white-labeled instances of the platform to their underlying employer clients. The company is founder-led with no disclosed venture or private equity investment, has operated for over a decade, and reported approximately 50% client growth in 2025 alongside an updated platform and new AI features, indicating active commercial expansion without external institutional backing.

Name

Prescription Care Management

Legal name

Prescription Care Management, LLC

Website

https://pcmsavings.com

Company type

Private

Founded year

2014

Operating status

Operating

Headcount range

11–50 employees

Short description

Prescription Care Management provides a HITRUST-certified cloud analytics platform for pharmacy and medical benefit cost containment, contract validation, and clinical engagement. It sells subscription access with bundled expert services through brokers, pharmacy consultants, TPAs, and self-insured plan sponsors.

Ownership category

akta.pro rank

Product category

Pharmacy Benefit Management Software

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Custom Computer Programming Services (541511)

SIC

Services-Prepackaged Software (7372), Services-Computer Programming, Data Processing, Etc. (7370), Hospital & Medical Service Plans (6324)

akta.pro primary industry

PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL)

akta.pro secondary industry

Medication Therapy Management (MTM) & Clinical Pharmacy Services Tools (HLACAKAH)

Keywords

• Pharmacy benefit management
• PBM contract auditing
• Prescription cost containment
• Health benefits analytics
• Self-insured plan management

Headquarters

HQ city

Seattle

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. Platform Subscription / SaaS: PCM operates as a software/SaaS platform providing subscription-based access to their interactive platform, analytics tools, and reporting capabilities. All products and solutions come with expert service built in.
2. Pharmacy Savings Programs: Revenue generated from pharmacy savings programs including PCM Rx Savings, which provides 8-10% average savings on total spend through physician engagement and drug switching.
3. Contract Audit and Validation Services: Fees for Rx contract performance audits, market checks, and contract benchmarking services.

Pricing tiers

Go-to-market motion3 records

Distribution channels4 records

Marketing channels7 records

Core offering

Prescription Care Management (PCM) operates a proprietary cloud-based analytics platform that aggregates pharmacy and medical claims data to deliver visibility, contract validation, and cost-containment services for self-insured health plans. The platform combines Rx analytics, PBM contract benchmarking, clinical engagement tools (including drug-switching programs), and customizable reporting in a white-labeled offering sold primarily to benefit brokers, consultants, third-party administrators (TPAs), and self-insured plan sponsors.

Product overview

Prescription Care Management (PCM) offers a unified platform architecture combining multiple integrated modules for pharmacy and medical benefit management. The core Interactive Platform serves as the central hub, integrating Data Integration & Monitoring (with Rx Analytics, Medical Analytics, and File Management), Rx Benefit Plan Services (with Rx Market Check, Rx Performance, and Rebate Management), Clinical Engagement (with PCM Rx Savings and Clinical Review), and Report Builder. The platform is HITRUST CSF certified and processes both pharmacy and medical claims data to provide claims-level visibility, cost validation, and actionable insights for brokers, TPAs, consultants, and self-insured plans.

Differentiator

Problem solved

Functional benefit

Brands

• A.P.S. (Alternative Prescription System): A proprietary system that works in conjunction with existing pharmacy plans to advise cheaper alternatives to expensive medications, providing prescription cost savings through therapeutic alternatives and generic substitutions.

Products and services

• Interactive Platform An all-in-one cloud-based SaaS platform for managing pharmacy and medical benefits, combining data integration, Rx and medical analytics, clinical engagement, contract evaluation, and reporting for benefit brokers, consultants, TPAs, and self-insured plan sponsors.
• PCM Rx Savings Standalone pharmacy savings program delivered via a dedicated Rx Engagement Team that engages prescribing physicians to switch participants from high-cost to clinically appropriate lower-cost drugs, yielding an average 8-10% reduction in total pharmacy spend and validated PMPM savings for self-insured plans.
• Alternative Prescription System (A.P.S.) PCM's original standalone pharmacy savings program that works alongside existing pharmacy plans, supported by a network of clinical physicians and pharmacists, to advise cheaper therapeutic alternatives and generic substitutions and reduce prescription spend.

Quantifiable outcome

• 8-10% savings on total spend
• +6 more outcomes

Named customers2 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

AI capability5 records

Feature10 records

Partnerships

Six partnerships are on record, tiered core and minor.

• Benefit BrokerscoreChannel Partner/ Reseller/ DistributorPCM works with benefit brokers as channel partners, providing tools that help brokers simplify plan management, sell with visibility, and grow their business. The platform supports broker workflows including RFP, reporting, and vendor validation.
• TPAs (Third-Party Administrators)coreChannel Partner/ Reseller/ DistributorTPAs utilize PCM's Market Check tool in partnership with brokers and consultants to conduct PBM contract evaluations or RFPs for their self-funded employer customers. Platform is white-labeled and customizable for TPA use.
• Pharmacy ConsultantscoreChannel Partner/ Reseller/ DistributorRx consultants partner with PCM for client management, using built-in service and technology to optimize benefit management. PCM provides white-labeled customer experience options for consultant partners.
• Self-Insured PlanscoreChannel Partner/ Reseller/ DistributorPCM provides direct support to self-insured plan sponsors with claims-level visibility, contract validation, and cost-containment solutions including pharmacy savings programs.
• Physician NetworkcoreStrategic or Co-development PartnerPCM has a network of clinical physicians and pharmacists who support the Alternative Prescription System, making suggestions aligned with patient needs and ensuring decisions involve the patient's doctor.
• Healthcare ProvidersminorStrategic or Co-development PartnerPCM engages members and providers to act on high-cost drugs. The dedicated support team and automated system can implement vendor programs, and clinical review solutions involve healthcare providers for patient-focused care.

Scale indicators5 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• SmithRx: SmithRx is a transparent PBM serving self-funded employers with a technology-forward approach to pharmacy benefit management. Comparable to PCM's analytics and contract-validation offerings, though SmithRx operates as the PBM rather than a third-party oversight layer.
• Capital Rx: Capital Rx is a health technology company operating a transparent PBM (JUDI) and benefit management platform. It overlaps with PCM in providing PBM technology, analytics, and contract transparency tools for self-funded plans, though Capital Rx also acts as a PBM itself.
• RxBenefits: RxBenefits is a PBM consulting and analytics firm focused on self-funded employer health plans. Like PCM, it serves benefit brokers and TPAs with PBM contract evaluation, market checks, and ongoing pharmacy benefit oversight, making it the closest direct competitor.
• Benecard PBF: Benecard PBF is a transparent PBM focused on self-funded plans with pass-through pricing and clinical programs. Shares PCM's mission of providing visibility into pharmacy benefit spend, with overlapping customer segments in mid-market employers.
• EmpiRx Health: EmpiRx Health is a PBM emphasizing clinical engagement, transparency, and outcomes-based pricing. Similar to PCM's clinical engagement and savings programs, it serves self-funded plans with analytics-driven pharmacy management.
• Artemis Health: Artemis Health is a benefits analytics platform that helps self-funded employers and brokers understand healthcare claims, utilization, and spend. Directly comparable to PCM's analytics modules, with overlapping customer base among benefits consultants and TPAs.

Broad incumbents

• MedImpact Healthcare Systems: MedImpact is an independent PBM with technology platforms for pharmacy benefit management. While larger and offering PBM services directly, it overlaps with PCM in serving self-funded plans and providing analytics tools.
• Mercer (Marsh McLennol): Mercer is a global benefits consulting firm that advises employers on PBM contracting and conducts market checks. As a broad incumbent in the benefits consulting space, Mercer represents both a potential competitor and partner channel for PCM-style analytics.
• Benefitfocus (Voya): Benefitfocus is a benefits administration and analytics platform serving employers, TPAs, and brokers. PCM's VP of Growth came from Benefitfocus, signaling direct competitive overlap in benefits data and analytics tooling.

Emerging players

• Quartz Health Solutions: Quartz Health Solutions provides pharmacy benefit analytics and transparent PBM services for self-funded employers. Overlaps with PCM in serving mid-market self-funded plans with cost-containment analytics and clinical programs.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/prescription-care-management

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 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 Prescription Care Management