US Pharmacy Benefit Management Market is Expected to Grow at a CAGR of over 5.53% During 2022-2027
Dublin, June 02, 2022 (GLOBE NEWSWIRE) -- The "Pharmacy Benefit Management Market in the US - Industry Outlook & Forecast 2022-2027" report has been added to ResearchAndMarkets.com's offering.
The study considers a detailed scenario of the present U.S. pharmacy benefit management market and its market dynamics for 2022-2027. It covers a detailed overview of several industry growth enablers, restraints, and trends. The report offers both the demand and supply aspects of the market. It profiles and examines leading companies and other prominent ones operating in the market.
The U.S. pharmacy benefit management market is expected to grow at a CAGR of 5.53% during 2022-2027
MARKET INSIGHTS
The PBM industry refers to companies that act as intermediaries between insurance companies, pharmacies, and pharmaceutical companies. PBM is responsible for reducing insurers and their drug costs. They achieve this by negotiating with pharmacies and pharmaceutical companies. The pharmacy benefit management systems entered the pharmaceutical industry in the 1960s to meet the needs of employer-based health benefits. They soon became an important stakeholder in the entire pharmaceutical supply chain.
Pharmacy costs represent almost 32% of the total health care spending, and this expenditure is expected to grow more than two times during the forecast period. Currently, pharmacy benefit management plays a major role and acts as an intermediary between payers, drug manufacturers, and pharmacies.
Since PBMs play a significant role in influencing out-of-pocket costs and patient access to medications owing to their management tools, formulary power, and price concessions. They are in a position of power to pass savings to customers. According to PBM lobby groups, between 2020 to 2029, PBM tools will reduce consumer and plan sponsors' spending by more than $1 trillion.
There is a growing criticism of PBMs with claims that they are driving up costs of drug prices, making huge gains via pharmacy spreads, rebates from manufacturers, and fees from the supply chain. This is being spurred by the opaqueness of the true cost of drugs to PBMs owing to the rules of engagement between manufacturers and PBMs.
The future of PBMs is going to be dictated by the implementation of state and national-level policies in terms of their revenue streams and business practices in the pharmaceutical space.
U.S. Pharmacy Benefit Management Market Segmentations
Based on services, specialty pharmacy services are the major contributor to the pharmacy benefit management market in the US, and it is likely to witness high incremental growth of $48.24 billion during the forecast period.
Based on health plans, commercial health plans are the major contributor to the pharmacy benefit management market in the US, and it is likely to witness high absolute growth of 34.69% during the forecast period.
Segmentation by Health Plan
Commercial Health Plans
Medicare
Medicaid
Others
Segmentation by Services
Specialty Pharmacy Services
Retail Pharmacy Networks
Mail-Order Pharmacy Services
Claims Processing
Formulary Management
Drug Utilization Review
Price, Discount, & Rebate Negotiations
Disease Management & Adherence Initiatives
Segmentation by Business Model
Insurance Companies and Retail Pharmacies
Pure Play PBMS
VENDOR ANALYSIS
The presence of prominent market players, increasing favorable healthcare reforms, rising e-prescription, and growing adoption of healthcare plans by us residents are the primary factors for the significant market share in the country.
Key Company Profiles
CVS Health
Cigna
UnitedHealth Group
Key Companies to Watch
Humana Pharmacy Solutions
Medimpact
Prime Therapeutics
Other Prominent Vendors
Abarca Health
AscellaHealth
BeneCard PBF
CaptureRx
Centene
Change Healthcare
Citizens Rx
EnvisionRxOptions
Excelera
Magellan Rx Management
MedalistRx
MaxorPlus
Navitus Health Solutions
PerformRx
ProCare Rx
RxAdvance
Rite Aid
WellDyneRx
Walgreens Boots Alliance
Market Opportunities & Trends
Increased Adoption of E-Prescription & Mail Order Pharmacy
Growing FDA Approvals of Biologics & Biosimilars
Market Entry of Payers Through M&As
Entry of Digital Health Solutions in the PBM Industry
Market Growth Enablers
Favorable Healthcare Reforms
Growing Adoption of Healthcare Plans by US Residents
Prevalence of Fraud, Waste & Abuse in Healthcare
Increased Demand for Personalized Medicines
Market Restraints
PBMs More Susceptible to Lawsuits & Government Scrutiny
Lack of Transparency in Services by PBMs
Declining Growth from Generics
Legal Uncertainty & Impending Limitations on PBM Tools
For more information about this report visit https://www.researchandmarkets.com/r/v9wyyf
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