Pharmacy Benefits Management
OrionRx is a complete, standalone PBM built for clarity and control. We give benefits consultants transparent pricing, clinical expertise, flexible plan strategies, and dependable service.
Your clients need more than a lower number on a spreadsheet
Pharmacy costs are rising. Specialty medications are reshaping plan budgets. And too many PBM arrangements make it difficult to see where the money goes, why decisions are made, or who will step in when a member needs help.
You need a PBM that makes the strategy clear and delivers what was promised.
OrionRx gives you a confident alternative: a transparent, clinically grounded pharmacy benefits partner that can serve any plan, with any TPA. We work as an extension of your team to help protect plan performance, member access, and the client relationships you have worked hard to build.
A full-service PBM with the expertise to guide and the flexibility to act
Formerly PinnacleRx Solutions, OrionRx is a complete pharmacy benefit manager with an identity and future of its own. Our name is inspired by a constellation that has guided people for generations. That same idea shapes how we work today: bring clarity to complexity, align the right partners, and help every plan move forward with confidence.
OrionRx can support any TPA or health plan as a standalone PBM. For clients who want a more integrated model, OrionRx can also coordinate with Pinnacle Health Solutions to connect medical and pharmacy benefits under one strategy.
Standalone by design
Bring OrionRx to any client without requiring a bundled health or TPA relationship.
Integrated when it matters
Connect medical and pharmacy data when a client wants one coordinated view of cost, risk, and care.
Built around people
Give employers and members access to experienced teams who respond, explain, and follow through.
Clear costs. Smarter care. Steady service.
Why benefits consultants choose OrionRx
A strategy you can recommend with confidence. OrionRx brings together cost control, clinical intervention, member access, and consistent service so the value goes beyond the initial proposal and holds up in practice.
Transparency you can verify
OrionRx provides clear visibility into pharmacy costs, rebates, fees, and performance. Our 100% rebate pass-through model returns negotiated rebates to the plan, and our no-spread approach removes hidden drug markups. Decisions stay focused on true net cost, not internal margin.
Clinical expertise that creates measurable value
Our clinical pharmacists use claims data to identify high-cost or non-optimal therapies, review safe alternatives, and engage prescribers directly. The goal is not to deny appropriate care. It is to improve medication decisions, protect member health, and reduce unnecessary spend.
Flexibility built around the client
No two populations are the same. OrionRx can tailor formularies, plan designs, clinical programs, and reporting around each employer’s goals without forcing every client into the same default strategy.
High-touch service beyond day one
Many PBMs compete hardest at implementation. OrionRx is built to remain responsive over the life of the relationship. Dedicated account management, accessible subject-matter experts, and structured plan reviews help you address issues quickly and keep strategy moving.
Independence without isolation
OrionRx offers the agility and accountability of an independent PBM, supported by a national pharmacy network and experienced clinical, implementation, analytics, and service teams. We do not own pharmacies, so our incentives stay aligned with the plan and its members.
Proof points you can stand behind
Pharmacies nationwide
including major chains and local independents
Rebate pass-through to the plan
Potential year-one savings
on specialty drug spend through clinical intervention
PBM implementation audit compliance rate
On-time implementation go-live rate
Clinical Intervention Savings Program
Better savings should never come at the expense of better care. OrionRx pharmacists work directly with prescribers to find lower-cost, clinically equivalent therapies without relying on denial-based savings. Provider education drives approximately two-thirds of program savings, helping plans reduce specialty drug spend by up to 22% in the first year while supporting safer prescribing and lasting value.
Transparent Rebate Program
You should never have to search for the truth behind your pharmacy costs. OrionRx returns 100% of rebate dollars to the plan, with no spread pricing or hidden prescription markups. Clear reporting shows clients where their money goes, while the option to apply projected rebates to TPA administrative fees can support healthier cash flow.
Custom Formulary Strategy
Every client population is different. OrionRx builds formularies around the people a plan serves, balancing clinical priorities with financial goals instead of defaulting to a one-size-fits-all model. Thoughtful use of tiers, targeted exclusions, generic-first strategies, step therapy, and utilization controls helps manage spend while preserving appropriate access to care.
Coupon & Copay Organization
The right cost-sharing strategy can guide better choices without placing more burden on members. With clinical oversight, OrionRx uses copays and available manufacturer assistance to encourage effective generics and preferred brands. The result is less unnecessary brand and specialty utilization, lower average prescription costs, and more predictable long-term spend.
Analytics & Insights
Data is most valuable when it gives you a clear next step. Through PERC, OrionRx brings together on-demand reports, real-time dashboards, benchmarks, predictive modeling, and custom reporting so clients can see emerging cost drivers sooner, understand what is changing, and act with confidence.
Clinical Pharmacy Team
Behind every prescription is a person—and a decision that matters. OrionRx pharmacists review therapies, collaborate with prescribers, and help members navigate clinically appropriate alternatives. Their hands-on guidance helps prevent unnecessary or unsafe prescriptions and turns better medication decisions into more sustainable savings.
National Pharmacy Network
A pharmacy benefit only works when members can use it where they live, work, and travel. OrionRx offers access to more than 68,000 pharmacies across all 50 states and Puerto Rico, from major national chains to trusted regional and independent pharmacies—all supported by transparent network pricing and no hidden markups.
Mail Order Program
For members who rely on maintenance medications, convenience can make a meaningful difference. The OrionRx Mail Order Program brings eligible prescriptions directly to the member’s home, making refills easier, supporting continuity of therapy, and removing everyday friction from the pharmacy experience.
Integrated TPA+PBM Model
When a client chooses both Pinnacle Health Solutions and OrionRx, medical and pharmacy data can work together under one coordinated strategy. That means fewer handoffs, clearer accountability, consolidated reporting, and earlier visibility into the cost drivers affecting total health plan performance.
- Simpler benefits administration
- Coordinated medical and pharmacy insights
- Aligned clinical strategies
- Streamlined communication and reporting
- One team accountable for the bigger picture
OrionRx also stands fully on its own. The right model is the one that fits your client.
OUR IMPLEMENTATION TIMELINE FOR PHARMACY BENEFITS MANAGEMENT
Structured implementation, with clarity at every step
Every implementation is supported by an experienced transition team, a customized timeline, and clear ownership of each task. OrionRx works closely with the consultant and client throughout discovery, system build, testing, training, and launch.
Plan Discovery & Benefit Design
Confirm benefits, formulary strategy, eligibility, clinical programs, and success measures.
System Build & Integration
Configure claims adjudication, data feeds, member materials, and reporting.
Client Training & Plan Testing
Validate the plan end to end and train client teams before launch.
Go-Live & Optimization
Support go-live, then continue with structured reviews and ongoing clinical and cost reporting.
Give your clients a clearer path through pharmacy benefits
For questions about pharmacy benefit management, your benefit plan, or need additional support, we can help. Fill out the following form and we’ll get back to you as soon as we can.
Want more information on OrionRx?
Visit our website orionrx.com.
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