Liviniti Marks 15-Year Milestone and Surpasses 1 Million Members as PBM Industry Faces Transparency Reckoning

NATCHITOCHES, La. – April 01, 2026 – As pharmacy benefit manager (PBM) Liviniti celebrates its 15-year anniversary and the major milestone of serving over one million people, it does so against the backdrop of a seismic shift in the American healthcare landscape. The company, founded in 2011 as Southern Scripts, has long championed a transparent, pass-through pricing model that is now moving from a niche alternative to the industry's focal point, propelled by intense regulatory pressure and growing employer demand for clarity and cost control.

While the anniversary marks a significant achievement in corporate longevity and growth, its true significance lies in the validation of a business model built to counteract the very practices that have drawn federal and state-level scrutiny to the PBM industry. Liviniti’s milestone is not just a corporate success story, but a signal of a broader market transformation.

"Reaching our 15-year milestone is a testament to the trust our clients place in us and the skill and dedication of Liviniti's employees," said LeAnn Boyd, co-founder and CEO, in a statement. "Reaching one million lives is more than a number. It represents families and communities who rely on us to make prescriptions more affordable, accessible, and easier to navigate, and reflects the relationships we've built together."

A Challenge to the Opaque Status Quo

The pharmacy benefit management industry has long been dominated by three major players—CVS Caremark, Express Scripts, and OptumRx—which collectively managed an estimated 80% of all U.S. prescriptions in 2024. This concentration of power has been criticized for fostering an opaque system where the true cost of drugs is obscured. Traditional PBM models often generate revenue through “spread pricing” (charging health plans more than they reimburse pharmacies) and by retaining a portion of the rebates negotiated with drug manufacturers, creating incentives that may not align with the lowest cost for employers or patients.

Liviniti was built as a direct challenge to this model. The company operates on a 100% pass-through basis, meaning it charges clients the exact same amount it pays the pharmacy for a drug. All rebates and discounts from manufacturers are returned directly to the employer. The company’s revenue comes from a straightforward, disclosed administrative fee, eliminating the hidden revenue streams that have fueled industry controversy. This approach, once seen as disruptive, is now gaining significant traction. Market data shows a dramatic shift, with employer use of alternative, transparent PBMs surging from 12% to 31% between 2024 and 2025, while reliance on the dominant players has begun to wane.

By focusing on the lowest net cost for a drug rather than maximizing rebates, which can favor more expensive brand-name medications, Liviniti claims it has saved its clients hundreds of millions of dollars. Independent analyses support the financial benefits of this approach, with some reports indicating that transparent PBMs can generate savings of as much as 30% for plan sponsors.

Riding a Wave of Regulatory Reform

Liviniti's growth coincides with an unprecedented wave of regulatory action aimed at forcing transparency and accountability upon the PBM industry. For years, employers and lawmakers have voiced concerns that opaque PBM practices contribute to rising prescription drug costs. Now, those concerns have translated into sweeping legislative and regulatory efforts.

At the federal level, the Federal Trade Commission (FTC) has intensified its investigations into PBM pricing strategies, while the Centers for Medicare & Medicaid Services (CMS) has implemented new rules requiring PBMs to disclose previously hidden rebate and fee information. Congress is also advancing multiple pieces of legislation, such as the Protecting Patients Against PBM Abuses Act, which aims to uncouple PBM compensation from drug prices and mandate flat-fee service models—a structure that mirrors Liviniti's existing framework.

Action at the state level is even more widespread. As of 2025, all 50 states have enacted some form of PBM transparency initiative. Over 30 states have passed laws restricting controversial practices like spread pricing and gag clauses that prevent pharmacists from telling patients about cheaper options. States like Ohio have already transitioned their public employee health plans to pass-through PBM models, and others are implementing laws that require rebates to be passed directly to consumers at the pharmacy counter. This regulatory tide is fundamentally reshaping the PBM market, creating a favorable environment for companies that have already built their foundations on transparency.

From Regional Startup to National Innovator

Liviniti’s journey from a regional startup to a national player with over a million members underscores its strategic foresight. Founded as Southern Scripts, the company rebranded to Liviniti in 2023 to better reflect its national scope and mission. The growth has been steady and significant, doubling in size since 2020 and expanding from 750,000 members to over one million in the past year alone.

This expansion has been fueled by both its transparent philosophy and a commitment to technological innovation. Rather than relying on legacy systems, Liviniti built its own flexible technology platform. This allows for rapid customization of benefit plans and provides clients with real-time data and analytics, offering the clarity that many employers now demand. The company has also developed targeted solutions to address modern healthcare challenges, including its "LivLite" program for managing the high costs of GLP-1 weight loss drugs and "RxCompass" for sourcing medications beyond traditional rebate-driven channels to find greater savings.

As the company looks to the future, its founding principles appear more relevant than ever. "Healthcare continues to evolve, and we will too as we anticipate a future of accelerated innovation and results," Boyd stated. In an industry being forcibly reshaped by demands for clarity, cost-effectiveness, and alignment with patient interests, Liviniti finds itself not just surviving, but thriving.