Veridicus Health

Veridicus Health, now operating as a part of Magellan Rx Management, was established in 2006 by Doug Burgoyne, PharmD, and Jeff Dunn, PharmD. Burgoyne, who served as CEO, had a background in leadership roles at other national Pharmacy Benefit Management (PBM) companies and a regional integrated delivery system affiliated with Intermountain Health Care before founding Veridicus. This experience was instrumental in shaping the company's approach to pharmacy solutions. The company began as a PBM organization, providing services to self-funded employers, third-party administrators, and plan sponsors.

The firm's business model centers on providing comprehensive and customizable pharmacy solutions. A key aspect of its operations involves leveraging proprietary analytics and clinical software that integrates pharmacy, medical, and lab data. This data-driven approach allows for targeted interventions, aiming to improve health outcomes and reduce costs for complex patient populations. Veridicus also owned and operated a licensed insurance company contracted with the Centers for Medicare and Medicaid Services (CMS) to serve members in the Medicare Part D Employer Group Waiver Plan (EGWP) program.

In a significant milestone, Magellan Health, Inc. announced its acquisition of Veridicus Holdings, LLC in late 2016 for $74.5 million, integrating it into its Magellan Rx Management division. The acquisition was a strategic move for Magellan to enhance its clinical management programs and value-based PBM services. Following the acquisition, the Veridicus team, including CEO Doug Burgoyne, joined Magellan Rx Management. The journey of acquisitions continued as Centene Corporation acquired Magellan Health in January 2022, which included Magellan Rx. However, in a subsequent strategic realignment, Centene divested Magellan Rx to Prime Therapeutics LLC in December 2022. Today, the entity operates as a stand-alone business unit within Prime, focusing on PBM services, specialty drug management, and state government solutions.

Keywords: pharmacy benefit management, PBM, clinical care management, medication therapy management, Medicare Part D, specialty pharmacy, health outcomes, data analytics, pharmacy solutions, self-funded employers, plan sponsors, Magellan Rx Management, Prime Therapeutics, Doug Burgoyne, specialty drug management, medical benefit, formulary management, state government solutions, cost containment, healthcare management