Overview and Scope
Pharmacy benefit management is a collection of businesses that function as intermediaries between insurance companies, pharmacies, and drug distributors. It is used to ensure that insurers and insurance companies pay reduced prescription costs by negotiating with pharmacists and medicine producers.
Sizing and Forecast
The pharmacy benefit management market size has grown strongly in recent years. It will grow from $597.17 billion in 2023 to $644.58 billion in 2024 at a compound annual growth rate (CAGR) of 7.9%. The growth in the historic period can be attributed to increased focus on preventative care, pharmacy network expansion, partnerships with healthcare providers, focus on patient outcomes, advancements in pharmaceutical therapies.
The pharmacy benefit management market size is expected to see strong growth in the next few years. It will grow to $878.37 billion in 2028 at a compound annual growth rate (CAGR) of 8.0%. The growth in the forecast period can be attributed to healthcare cost control demands, rise in prescription drug usage, health insurance expansion, adherence to regulatory changes, patient-centric healthcare. Major trends in the forecast period include value-based healthcare models, specialty medications management, data analytics and AI integration, telemedicine integration, rise in personalized medicine.
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Segmentation & Regional Insights
The pharmacy benefit management (PBM) market covered in this report is segmented –
1) By Services: Mail-Delivery, Specialty Pharmacy, Preferred Network Pharmacy
2) By Type: Commercial Health Plans, Self-Insured Employer Plans, Medicare Part D Plans, Federal Employees Health Benefits Program
3) By End User: Pharmacy Benefit Management Organization, Mail Order Pharmacies, Retail Pharmacies, Inpatient Pharmacies, Outpatient Pharmacies
North America was the largest region in the pharmacy benefit management market in 2023. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the pharmacy benefit management market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa.
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Major Driver Impacting Market Growth
The rise in the number of people availing insurance significantly contributes to the growth of the pharmacy benefit management market. Insurance provides a solution to deal with the increased medical costs by covering the expenses related to treatment, hospitalization, health check-ups, and hospitalization expenses. Similarly, pharmacy benefit management (PBM) supports end-to-end healthcare products by combining medical as well as pharmaceutical products. This enables the insurers to have extensive information regarding the patients that helps the insurers provide efficient programs to patients. For instance, according to the India Brand Equity Foundation (IBEF), new premiums of life insurers registered 22.2% growth in September 2021, up 2.9% from September 2020. Therefore, the rise in the number of people availing of insurance is driving the growth of the pharmacy benefit management market.
Key Industry Players
Major companies operating in the pharmacy benefit management market report are CVS Health Corporation, Cigna Corporation, Centene Corporation, Anthem Inc., OptumRx Inc., Humana Pharmacy Solutions Inc., Rite Aid Corporation, Magellan Health Inc., Prime Therapeutics LLC, MaxorPlus Ltd., RxAdvance Corp, MedImpact Healthcare Systems Inc., PerformRx LLC., Navitus Health Solutions LLC, WellDyneRx Inc., Healthesystems LLC., Catalyst Rx Inc., Argus Health Systems Inc., Innoviant Pharmacy Inc., Pharmaceutical Strategies Group, MedTrak Services LLC, ProCare Rx Inc., Managed Health Care Associates Inc., FutureScripts LLC., National CooperativeRx, ScriptCare Ltd., US Script Inc., LDI Integrated Pharmacy Services LLC, RxPreferred Benefits, ActiveRADAR Company, SinfoníaRx Inc.
The pharmacy benefit management market report table of contents includes:
1. Executive Summary
2. Pharmacy Benefit Management Market Characteristics
3. Pharmacy Benefit Management Market Trends And Strategies
4. Pharmacy Benefit Management Market - Macro Economic Scenario
5. Global Pharmacy Benefit Management Market Size and Growth
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32. Global Pharmacy Benefit Management Market Competitive Benchmarking
33. Global Pharmacy Benefit Management Market Competitive Dashboard
34. Key Mergers And Acquisitions In The Pharmacy Benefit Management Market
35. Pharmacy Benefit Management Market Future Outlook and Potential Analysis
36. Appendix
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