Pharmacy Benefit Management System (PBMS)
PBMS Background
Historically, Colorado’s Pharmacy Benefit Management System (PBMS) has been managed as one solution with one vendor. Prime Healthcare (formerly known as Magellan) has been the vendor for Colorado’s PBMS since 2017. Prime’s contract ends in February 2026.
PBMS Transition
The legacy PBMS, implemented in 2017, is the foundation for five PBMS modules that will be implemented in the CMES ecosystem.
The table below provides an overview of the PBMS modules and their anticipated changes.
Module | Current Vendor | New Vendor | Go Live |
|---|---|---|---|
Pharmacy Benefit Management System | Prime Therapeutics | MedImpact | Winter 2026 |
Rebate Administration | Fall 2025 | ||
Preferred Drug List | Fall 2025 | ||
Real-Time Benefit Tool | Winter 2026 | ||
Opioid Risk | OpiSafe | OpiSafe | N/A |
What is changing?
Four modules are being transitioned from the current vendor, Prime Therapeutics (Prime), to a new vendor, MedImpact. The transition of the PBMS modules to MedImpact will enable flexibility, configurability, scalability, and interoperability for the pharmacy program. The modules transitioning from Prime to MedImpact are:
- Pharmacy Benefit Management System
- Rebate Administration
- Preferred Drug List
- Real-Time Benefit Tool
What is staying the same?
The Opioid Risk module will remain with the current vendor, OpiSafe.
Send questions or comments to hcpf_cmes@state.co.us.