According to the latest report by IMARC Group, titled “Pharmacy Benefit Management Market: Industry Trends, Share, Size, Growth, Opportunity and Forecast 2021-2026”, the global pharmacy benefit market grew at a CAGR of around 6% during 2015-2020. Pharmacy benefit management (PBM) is a system wherein a third-party administrator manages prescription drug programs on behalf of health insurers, pharmacies, drug manufacturers, etc. PBM performs significant operations, including retail pharmacy services, drug formulary management, disease management services, benefit plan design and consultation, financing and setting dispensing policies, etc. This system also conducts generic drug substitution along with negotiating drug rebates with manufacturers and pharmacies.
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The market is primarily catalyzed by the escalating need for cost management services due to the rising prevalence of chronic diseases and soaring healthcare expenditures. Furthermore, the growing presence of similar drugs in the market with minimal difference in their APIs has resulted in the increasing price sensitivity of these drugs. Consequently, there is a growing demand for PBM systems that release drug formularies for all drugs covered under their benefit plans, wherein manufacturers are receptive to provide discounts and offers. Additionally, the increasing number of partnerships between PBM organizations and health insurance companies for improved affordability and personalization of health insurance plans is also propelling the global market growth. Moreover, the introduction of advanced benefit management services pertaining to disease management, drug utilization, and pharmacy-medical integrated products, will continue to further drive the market for PBM. Looking forward, IMARC expects the global pharmacy benefit management market to exhibit continuous growth during 2021-2026.
Breakup by Service:
- Specialty Pharmacy Services
- Drug Formulary Management
- Retail Pharmacy Services
- Benefit Plan Design and Consultation
- Disease Management Services
- Others
Breakup by Business Model:
- Health Insurance Management
- Standalone PBMs
- Retail Pharmacy
Breakup by End Use:
- Federal
- Commercial
Competitive Landscape with Key Player:
- Aetna, Inc.
- Centene Corporation
- Cigna Corporation
- CVS Health Corporation
- Express Scripts Holding Company
- Magellan Health Inc.
- Medimpact Healthcare Systems Inc.
- Optumrx Inc.
- Prime Therapeutics LLC
- ProCare Rx
- SS&c Technologies
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