Abarca Health and LucyRx - two privately held independent pharmacy benefit management companies - have agreed to merge as an alternative to the nation’s largest PBMs and as the public seeks better prescription drug prices. The combination of Abarca and LucyRx will create a pharmacy benefit management business that will serve more than 9 million plan members across the U.S. in a deal designed to “create the only modern, independent pharmacy benefit manager with the scale, technology, and track record to credibly serve commercial and government clients of any size,” the companies announced Wednesday, June 17, 2026.

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News independent pharmacy benefit managers Abarca Health and LucyRx will merge into an alternative to the nation’s three largest PBMs may not be the last announcement regarding combinations of smaller industry players.

The Abarca-LucyRx deal will put the combined company in the top 10 PBMs when it comes to number of prescriptions managed but still far smaller than the three largest PBMs that control 80% of the U.S. market. Those three are: CVS Health’s Caremark; Express Scripts, which is owned by Cigna; and OptumRx, which is owned by UnitedHealth Group.

Pharmacy benefit managers work as middlemen of sorts between insurers, pharmacies, and drug manufacturers to negotiate drug prices and manage prescription benefits.

The PBM market lately has been under unprecedented scrutiny with practically every state in the country, along with the U.S. government, looking at PBM business practices while transforming regulations and pushing for greater transparency. The big three PBMS, in particular, have been subject of a Federal Trade Commission inquiry into anticompetitive behavior that government attorneys say resulted in inflated drug prices. The companies have denied the allegations.

After the big three, the next largest PBMs include Humana Pharmacy Solutions, MedImpact Healthcare Systems and Prime Therapeutics and they don’t even crack 16% of the U.S. market combined, according to Drug Channels.

But the smaller PBMs are less able to withstand the added costs from this mountain of regulations that industry analysts and companies say are adding to administrative expenses at a time the PBMs are trying to keep a lid on the costs of prescription drugs for their clients. Already, pharmacy is the fastest growing component driving employer and worker health costs.

“The growing administrative complexity of state and federal regulation will disproportionately burden smaller PBMs that lack the scale, capital, and integrated infrastructure of the largest organizations,” Adam J. Fein, President of Drug Channels Institute, wrote in an analysis last month of the PBM market. “Over the next five years, we expect many smaller PBMs to disappear through acquisition, consolidation, or business failure.”

To be sure, executives at Abarca and LucyRx believe others in the PBM industry will be looking for partners.

"The same forces that shaped this combination will continue to reshape the industry,” said Abarca chief executive officer Jason Borschow.

"The market is at a breaking point,” Borschow added. “Clients are demanding real accountability. And the regulatory environment increasingly rewards scale and transparency.”

Both Abarca, which is based in San Juan, Puerto Rico, and LucyRx, which is based in Bethesda, Maryland, will retain their brands and operate as wholly owned subsidiaries of a company called Healthcare Revolution Partners once the deal closes in the third quarter of this year, pending regulatory approvals.

“This is about creating a model for what the market can and should become, not just what Abarca and LucyRx can accomplish together,” Borschow, who will be co-chair of Healthcare Revolution Partners, said.

LucyRx chief executive officer David Blair, the other co-chair of Healthcare Revolution Partners, said the “rapidly evolving prescription care landscape is fundamentally reshaping how pharmacy benefits are managed.”

“New transparency requirements and administrative obligations, along with the continued introduction of new high-cost medications and direct-to-consumer drug manufacturer programs, are raising the bar for every player in this market,” Blair added. “Organizations that can build the operational scale to meet those demands while still delivering for clients and patients will be best positioned to lead. That’s exactly what the Abarca and LucyRx combination is designed to do, and is where the market is headed.”