Alluma

What Alluma does

Alluma is a private Pharmacy Benefits Manager (PBM) founded in 2019 as a joint venture between Mayo Clinic and Vizient Inc., headquartered in Irving, Texas. The company provides pharmacy benefit management services to health systems, integrated delivery networks, and employer groups, differentiating itself from traditional PBMs through a provider-led model in which revenue is independent of drug utilization and 100% of rebates and savings are passed through to clients without spread pricing or hidden margins.

The company's product platform centers on three tiered formularies (Alluma Advantage, Alluma Access, and Alluma Care) supported by a Member Portal (powered by Express Scripts and Medica), mobile applications, and an electronic prior authorization (ePA) capability integrated with CoverMyMeds and Surescripts to connect prescriber EHRs directly to Alluma's authorization workflows. Add-on modules include 340B pricing optimization, embedded Clinical Pharmacy Services staffed by healthcare pharmacists, and Real-Time Reporting that provides visibility into pharmacy spend and cost drivers.

Commercially, Alluma operates a sales-led GTM targeting enterprise health systems and employer groups, leveraging Vizient's administrative infrastructure and nationwide Express Scripts pharmacy network. Disclosed performance metrics include a 30:1 return on admin fee in 2023, 20% higher fill rate versus market, 15% higher formulary compliance versus the Employer-Hospital Benchmark, and 49% of claims captured equating to 51% of revenue on average with the Alluma model.

Name

Alluma

Legal name

Alluma, LLC

Website

https://allumaco.com

Company type

Private

Founded year

2019

Operating status

Operating

Headcount range

11–50 employees

Short description

Alluma is a provider-led Pharmacy Benefits Manager co-founded by Mayo Clinic and Vizient, offering transparent, pass-through PBM services with 100% rebate pass-through to health systems and employer groups.

Ownership category

akta.pro rank

Product category

Pharmacy Benefits Management

NAICS

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

SIC

Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

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

akta.pro secondary industries

PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL), 340B Program Administration & Support (HLAEAKAJ), Pharmacy Benefit Analytics, Reporting & Employer Consulting (HLAEAKAK)

Keywords

• Pharmacy benefits management
• Transparent PBM services
• Electronic prior authorization
• 340B pricing optimization
• Clinical pharmacy services

Headquarters

HQ city

Irving

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, Infrastructure

Revenue model

1. PBM Administrative Fees: Alluma operates on a transparent, pass-through model where revenue is independent of drug utilization. The company earns administrative fees and passes through 100% of rebates and savings to clients. This creates alignment where the company's success is tied to client outcomes rather than drug spend volume.

Go-to-market motion1 record

Distribution channels4 records

Marketing channels4 records

Core offering

Alluma is a provider-led Pharmacy Benefits Manager (PBM) that administers transparent, clinically aligned pharmacy benefit programs for health systems and employers. Its offering centers on a 100% rebate and savings pass-through administrative fee model, pharmacist-led clinical strategy, electronic prior authorization integrated with prescriber EHRs, and dedicated high-touch account teams serving as extensions of client organizations. The company is built on a partnership between Mayo Clinic and Vizient and does not own pharmacies, eliminating spread-pricing conflicts of interest inherent to traditional PBMs.

Product overview

Alluma is a provider-led, provider-focused Pharmacy Benefits Manager (PBM) offering a platform of interconnected services designed to replace traditional PBMs. The core offering includes Pharmacy Benefits Management with transparent fee structure and clinical alignment, supported by three named formulary tiers (Alluma Advantage, Alluma Access, and Alluma Care), a Member Portal for beneficiaries to manage prescriptions, and Electronic Prior Authorization (ePA) tools integrating with CoverMyMeds and Surescripts. Add-on modules include 340B Pricing Optimization, Clinical Pharmacy Services with embedded pharmacist expertise, and Real-Time Reporting. The model operates on a 100% rebate pass-through structure with revenue independent of utilization.

Differentiator

Problem solved

Functional benefit

Brands

• Pharmacy Benefits Illuminators: Brand positioning tagline used by Alluma to differentiate its PBM services from traditional PBMs

Products and services

• Pharmacy Benefits Management

Quantifiable outcome

• 30:1 return on admin fee in 2023
• +3 more outcomes

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

Feature3 records

Partnerships

Eight partnerships are on record, tiered core, secondary and minor.

• Mayo CliniccoreStrategic or Co-development PartnerMayo Clinic is a co-founder of Alluma, bringing renowned clinical expertise to the partnership. This collaboration founded Alluma to transform the PBM industry by addressing rising drug costs, reducing complexities, and improving access to affordable medications.
• VizientcoreStrategic or Co-development PartnerVizient is a co-founder of Alluma, contributing industry-leading knowledge in supply chain management and operational efficiency. Vizient also manages the privacy of the organization and provides administrative infrastructure.
• Express ScriptscoreTechnology or IntegrationExpress Scripts provides pharmacy benefit services and powers the member portal for Alluma. They also manage the nationwide pharmacy network and handle network compliance for pharmacies.
• MedicasecondaryTechnology or IntegrationMedica provides member portal access for Medica health plan members covered under Alluma-administered pharmacy benefits.
• CoverMyMedscoreTechnology or IntegrationCoverMyMeds provides electronic prior authorization (ePA) submission platform integrated with Alluma's authorization systems, enabling efficient PA requests through EHR connectivity.
• SurescriptscoreTechnology or IntegrationSurescripts provides electronic prior authorization (ePA) capabilities that connect electronic health record systems to Alluma's prior authorization systems for clinically sound coverage decisions.
• Accredo Specialty PharmacysecondaryOthersAccredo Specialty Pharmacy is listed as a pharmacy link for Alluma members requiring specialty medications.
• OmadaminorOthersOmada is a digital weight-management program that some health plans may require member participation in for coverage of weight-loss medications.

Scale indicators4 records

Recent moves6 records

Expansion highlights5 records

Emerging players

• RxBenefits: RxBenefits is a PBM and pharmacy benefits consultant focused on self-funded employers and emerging-mid-market segments. It overlaps with Alluma's employer vertical through a transparent pricing proposition.

Direct peers

• Capital Rx: Capital Rx operates a transparent, technology-led PBM (JUDGE platform) serving employers, health plans, and government programs. It is a direct competitor pursuing the same anti-spread-pricing value proposition as Alluma.
• SmithRx: SmithRx is a tech-enabled, transparent PBM focused primarily on self-funded employers. It competes head-to-head with Alluma in the employer segment using a similar pass-through rebate model and modern technology stack.
• Elixir Pharmacy Solutions: Elixir (formerly EnvisionRx) is a PBM serving employers and health plans with a focus on clinical management and transparent pricing. It competes with Alluma across employer and mid-market accounts.
• Navitus Health Solutions: Navitus is a transparent, pass-through PBM with a similar provider-friendly philosophy, serving health plans, employers, and government programs. It is the closest analog to Alluma's model and a direct competitor for transparent-PBM RFPs.
• MedImpact Healthcare Systems: MedImpact is an independent, pass-through PBM serving health plans, employers, and government programs. It is a direct competitor offering similar transparent pricing and clinical program capabilities.

Broad incumbents

• Humana Pharmacy Solutions: Humana Pharmacy Solutions is a top-five PBM serving Humana's own health plans plus external employer/group clients. It competes for the same health-system and employer accounts Alluma targets.
• Express Scripts (Evernorth): Express Scripts is Alluma's primary pharmacy-network partner while also being one of the three dominant PBM incumbents through Cigna/Evernorth. It is simultaneously a vendor and the largest competitive threat.
• OptumRx: OptumRx (UnitedHealth Group) is one of the three dominant U.S. PBMs controlling the majority of prescription claims. It is the incumbent that Alluma's transparent, no-spread-pricing model is positioned against.
• CVS Caremark: CVS Caremark (CVS Health) is one of the three dominant PBMs and the largest by prescription volume. It represents the legacy spread-pricing model that Alluma differentiates against.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/alluma-llc

Compliance3 records

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 Alluma