Nathan Downhour

Senior Vice President, Pharmacy and Care Solutions

As senior vice president, pharmacy and care solutions, Nathan Downhour leads the development, implementation and coordination of Prime’s pharmacy distribution and supply chain strategies to optimize our supply chain value, reduce unit costs and deliver better experiences to members utilizing our in-house and contracted mail and specialty pharmacies. 

Downhour joined Prime in 2021, building on a career-long record of leveraging operational expertise, financial acumen and stakeholder engagement to drive patient centric innovation and growth for leading independent and PBM-owned pharmacy businesses. He started his career in an operations role with The Apothecary Shops, which was rebranded to Avella in 2012. As executive vice president of operations and strategic programs at Avella, Downhour was a member of the executive leadership team that oversaw the scaling of the organization to a national specialty pharmacy with a focus in oncology and limited distribution medications. Avella was acquired by OptumRx in 2018. 

Following the acquisition, Downhour was retained by OptumRx as senior vice president of specialty pharmacy where he led the specialty growth and strategy team and was responsible for the P&L of OptumRx’s specialty pharmacy business. Downhour also led successful post-acquisition integrations of Avella and Diplomat Specialty Pharmacy into the OptumRx specialty pharmacy portfolio. 

Downhour earned his Doctor of Pharmacy from the University of Arizona, graduating summa cum laude. He completed a pharmacy practice residency at Clarian Health in Indianapolis, Indiana.