MedImpact, a San Diego-based independent pharmacy benefit manager (PBM), has signed an agreement to acquire the PBM assets of VytlOne, including its affiliate Gateway Health Partners, one of the market’s leading third-party vendors managing rebate aggregation for smaller PBMs. The deal, announced on October 26, adds a rebate aggregator to MedImpact’s portfolio at a moment when federal law has put that layer of the drug supply chain under its most intense scrutiny yet.
VytlOne President Amy Garrigues, writing to clients on the day the deal was announced, said the transaction does not include VytlOne’s 340B, specialty pharmacy, or pharmacy fulfillment assets, which the company will retain. She said MedImpact’s scale and clinical capabilities “will provide even more choice and flexibility, additional tools to manage pharmacy costs and continued support for the best member experience.”
The agreement is MedImpact’s fourth significant transaction since February 2026. The San Diego-based company completed its acquisition of Sav-Rx, a PBM serving organized labor, in February, then acquired risk management firms MHW Benefit Partners and MSL Captive Solutions in March.
The VytlOne PBM deal is subject to customary regulatory review. Terms were not disclosed.
The company has also been active in prior years.In February 2024, it acquired Elixir Solutions from Rite Aid for approximately $576.5 million.
Gateway’s function is what makes this deal worth watching closely. Rebate aggregators sit between drug manufacturers and PBMs, pooling claims from multiple plans to negotiate manufacturer rebates. Smaller PBMs have historically relied on them to access pricing leverage they could not achieve independently. That dynamic also makes it difficult for employer plan sponsors to see exactly how much of a rebate they are actually receiving.
The Consolidated Appropriations Act, 2026, signed into law on February 3, directly targets this opacity. Under the new federal requirements, PBMs and the rebate aggregators and group purchasing organizations they contract with must pass through 100% of rebates and related remuneration to group health plans on a quarterly basis, according to a Morgan Lewis analysis of the legislation.
Semiannual reporting to plan sponsors on drug pricing, rebate flows, and compensation arrangements becomes mandatory, and plan sponsors gain annual audit rights over their PBM. Most requirements take effect for calendar-year plans on January 1, 2029.
Plan sponsors and the benefits advisers who serve them are now, for the first time, entitled by law to see the full economics of their PBM relationships, including the aggregator layer.
