Pharmastar

What Pharmastar does

Pharmastar is a U.S.-based Pharmacy Benefit Management (PBM) company headquartered in Altoona, Pennsylvania, that provides full-service pharmacy benefits administration primarily to Programs of All-inclusive Care for the Elderly (PACE). Founded in 2000, the company operates as the PBM brand under AnewHealth and holds exclusive endorsement from the National PACE Association as the preferred PBM provider for PACE organizations nationwide. Its platform delivers customized plan designs, Medicare Part D compliance and reporting, Prescription Drug Event (PDE) claim submissions to CMS, claims adjudication, rebate processing with direct manufacturer collaboration, and audit support. Pharmastar differentiates through a fully transparent pricing model with no pharmacy fees or spread pricing, and serves 121 PACE partners with approximately 66,000 participants and 10 million gross claims processed in 2024.

The company has extended its PBM capabilities beyond PACE to serve Medicare, Medicaid, and dual-eligible health plans as well as risk-bearing providers such as accountable care organizations and physician groups. Its technology infrastructure emphasizes regulatory accuracy and reporting timeliness, with PDE reports submitted twice monthly to CMS and detailed monthly reporting to partner organizations. Pharmastar operates as a B2B enterprise services provider with direct sales to healthcare organizations, high-touch account management, and a consulting-oriented partnership model. The company reports a 100% client retention rate since 2023 and positions itself as an integrated component of AnewHealth's broader pharmacy care management ecosystem, which spans pharmacy-at-home, specialty pharmacy, risk adjustment, and PACE consulting services.

The business model is built on managed-services revenue from PBM contracts with healthcare organizations, with pricing structured around customized, quote-based organizational partnerships rather than publicly disclosed rate cards. Pharmastar's competitive positioning rests on PACE-specific regulatory expertise, transparent economics versus traditional spread-pricing PBMs, and the National PACE Association endorsement, which collectively create barriers to entry in the PACE vertical. The company employs 51-100 people and operates exclusively within the United States domestic market, with stated capacity to scale claims processing infrastructure to support growth.

Name

Pharmastar

Legal name

Pharmastar

Website

https://pharmastarpbm.com

Company type

Private

Founded year

2000

Operating status

Operating

Headcount range

51–100 employees

Short description

Pharmastar is a U.S. pharmacy benefit management company serving 121 PACE programs and health plans with transparent pricing, Medicare Part D compliance, claims processing, and rebate administration under AnewHealth.

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)

akta.pro primary industry

Pharmacy Benefit Management (PBM) & Pharmacy Network Administration (HLAFALAI)

akta.pro secondary industries

Claims Processing, Adjudication & Payment Integrity (HLAEAKAC), Manufacturer Contracting, Rebates & Revenue Management (HLAEAKAD), Pharmacy Benefit Management (PBM) & Formulary Management IT (HLACAKAD)

Keywords

• Pharmacy benefit management
• PBM services
• Medicare Part D
• PACE pharmacy programs
• Prescription drug benefits

Headquarters

HQ city

Altoona

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Pharmacy Benefit Management Services: Full-service PBM providing prescription drug benefits, claims processing, rebate management, and regulatory compliance for healthcare organizations including PACE programs and health plans

Go-to-market motion1 record

Distribution channels1 record

Marketing channels2 records

Core offering

Pharmastar is a full-service Pharmacy Benefit Management (PBM) company operating as a brand under AnewHealth. It provides pharmacy benefit management services including prescription drug benefit administration, claims processing, pharmacy network management, and Medicare Part D rebate processing primarily to PACE programs, health plans, and risk-bearing providers.

Product overview

Pharmastar is a Pharmacy Benefit Management (PBM) company that offers a unified, full-service PBM platform designed primarily for PACE programs and insurers. The company provides a comprehensive suite of services including customized plan design, Medicare Part D reporting, prescription drug event (PDE) submission, claims adjudication, rebate processing, and audit support. As the exclusive PBM endorsed by the National PACE Association, Pharmastar delivers services through a fully transparent model with no pharmacy fees or spread pricing, integrating pharmacy services with PBM capabilities to help organizations achieve cost savings while ensuring beneficiary access to medications.

Differentiator

Problem solved

Functional benefit

Products and services

• Pharmastar Pharmacy Benefit Management (PBM) Services Full-service pharmacy benefit management including claims processing, pharmacy network management, formulary administration, and clinical services for PACE programs, health plans, and risk-bearing providers.
• Medicare Part D Prescription Drug Plan Services Medicare Part D benefit administration including CMS reporting, PDE claim submission, and rebate processing for participating programs.

Quantifiable outcome

• 100% client retention rate since 2023
• +3 more outcomes

Segments3 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

One partnership is on record.

• National PACE AssociationcoreStrategic or Co-development PartnerPharmastar is the exclusive PBM endorsed by the National PACE Association, providing solutions specifically designed to meet the unique needs of PACE programs. This endorsement represents a significant strategic partnership positioning Pharmastar as the preferred PBM provider for PACE organizations across the U.S.

Scale indicators5 records

Recent moves1 record

Expansion highlights4 records

Emerging players

• Capital Rx: Technology-forward transparent PBM with a proprietary adjudication platform, targeting employer plans and government programs. Overlaps with Pharmastar on the transparent-pricing differentiator and on competing for the same Medicare/Medicaid plan RFPs.
• SmithRx: Transparent, pass-through PBM focused on self-funded employers with a modern tech platform. Comparable to Pharmastar's transparent model and as an emerging alternative to incumbents in adjacent plan-sponsor segments.

Direct peers

• MedImpact Healthcare Systems: Independent, transparent PBM serving health plans, employers, and government programs. Closely comparable to Pharmastar as a non-big-3 PBM competing on transparency and service, with overlap in Medicare/Medicaid administration.
• PerformRx: PBM owned by AmeriHealth Caritas, focused on Medicaid, Medicare, and dual-eligible populations. Directly comparable to Pharmastar on serving government-sponsored, dual-eligible plans and on Part D/Medicaid administration.
• Navitus Health Solutions: Pass-through, transparent PBM owned by SSM Health and Costco. Direct comparable to Pharmastar on the transparent-pricing thesis and on serving mission-driven, health-system, and government-sponsored plan sponsors.
• Elixir PBM: Mid-sized PBM specializing in Medicare Part D and retiree drug programs, with transparent pricing offerings. Comparable to Pharmastar on Part D focus and on serving regional/specialty plan sponsors.

Broad incumbents

• Express Scripts (Cigna): Largest U.S. PBM by script volume, embedded in Cigna's Evernorth. Comparable as the dominant spread-pricing incumbent Pharmastar competes against; relevant for benchmarking scale, rebate leverage, and Part D capabilities.
• CVS Caremark: PBM arm of CVS Health and a top-3 U.S. PBM. Comparable as a broad incumbent PBM with extensive Part D and Medicare Advantage footprint that competes with Pharmastar for health-plan and PACE-adjacent contracts.
• Humana Pharmacy Solutions: Medicare Advantage-focused PBM integrated with Humana's health plan. Comparable to Pharmastar on deep Part D/MA expertise and on serving senior-focused plan sponsors, including PACE-adjacent dual-eligible populations.
• OptumRx (UnitedHealth Group): Largest PBM by prescription revenue, integrated with UnitedHealthcare's health plan. Comparable as the dominant incumbent Pharmastar positions against on transparency, scale, and integrated payer-PBM economics.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/pharmastarpbm
• Facebookexactcare.info/facebook
• LinkedInlinkedin.com/company/pharmastar-pbm

Revenue estimate

Valuation estimate

Number of profiles

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 Pharmastar