Industry Outlook
The global pharmacy benefit management market was valued at US$ 405.4 Bn in 2021 and expected to grow at compound annual growth rate (CAGR) of 5.4% during the forecast period from 2023 to 2030. Pharmacy benefit managers (PBM) are an organization that provides educational programs and services to aid healthcare seekers. The PBM acts an intermediary between insurers and healthcare providers by negotiating with both pharmaceutical companies and pharmacies to get the best rates. PBMs are also involved in the determining the retail prices of the pharmaceutical products, discuss rebates from pharmaceutical manufacturers on the basis of total sales volume of products, and attain post sale price discounts and repayments from pharmacies. PBMs use their utilization management and buying power to lower the cost of pharmaceuticals. Most of the payers choose to contract with PBMs rather than procuring drug internally. Commercial insurers, Medicare and Medicaid are the major end-users for PBMs. Moreover, PBMs are also able to influence patients to move to less expensive brand drugs by playing brands off one another.
However, criticism over the PBM model in the recent past is acting as the major restraining factor for the growth of the market. The Medicare Payment Advisory Commission has been raising apprehensions regarding failure of choosing lowest-cost drugs by the PBMs. Moreover, a recent study indicated that PBMs are charging Medicaid managed care organizations more for generic drugs as compared to the actual price to be paid to the pharmacies. Thus, this concerns over PBMs working model will negatively affect the market during the forecast period. In 2021, specialty pharmacy services held the largest share in the global pharmacy benefit management market. Growing market consolidation due to mergers and acquisitions in the market will boost the specialty pharmacy services market.
The key players currently engaged in pharmacy benefit management market include CVS Health, Express Scripts Holding Company, Cigna, Anthem, Optumrx, Inc., Walgreens Boots Alliance, Inc., and Rite Aid Corp. among others.
Historical & Forecast Period
This study report represents analysis of each segment from 2022 to 2032 considering 2023 as the base year. Compounded Annual Growth Rate (CAGR) for each of the respective segments estimated for the forecast period of 2024 to 2032.
The current report comprises of quantitative market estimations for each micro market for every geographical region and qualitative market analysis such as micro and macro environment analysis, market trends, competitive intelligence, segment analysis, porters five force model, top winning strategies, top investment markets, emerging trends and technological analysis, case studies, strategic conclusions and recommendations and other key market insights.
Research Methodology
The complete research study was conducted in three phases, namely: secondary research, primary research, and expert panel review. key data point that enables the estimation of Pharmacy Benefit Management market are as follows:
Market forecast was performed through proprietary software that analyzes various qualitative and quantitative factors. Growth rate and CAGR were estimated through intensive secondary and primary research. Data triangulation across various data points provides accuracy across various analyzed market segments in the report. Application of both top down and bottom-up approach for validation of market estimation assures logical, methodical and mathematical consistency of the quantitative data.
| ATTRIBUTE | DETAILS |
|---|---|
| Research Period | 2022-2032 |
| Base Year | 2023 |
| Forecast Period | 2024-2032 |
| Historical Year | 2022 |
| Unit | USD Million |
| Segmentation | |
Services
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Business Model
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Region Segment (2022-2032; US$ Million)
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Key questions answered in this report
