Pharmacy Benefit Management Market By Services (Specialty pharmacy services, Benefit plan design and consultation, Drug formulary management, Other Services), By Demand Determinants (Government Health Programs, Employer-sponsored Programs, Health Insurance Management) - Growth, Future Prospects, Competitive Analysis, 2018 - 2026

Industry Outlook

The global pharmacy benefit management market was valued at US$ 405.4 Bn in 2017 and expected to grow at compound annual growth rate (CAGR) of 5.4% during the forecast period from 2018 to 2026. 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. 

Market Synopsis

Pharmacy Benefit Management Market

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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 2017, 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.

Pharmacy Benefit Management Market

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Historical & Forecast Period

This research report presents the analysis of each segment from 2016 to 2026 considering 2017 as the base year for the research. Compounded annual growth rate (CAGR) for each respective segments calculated for the forecast period from 2018 to 2026.

Report Scope by Segments

Pharmacy benefit management market report furnishes quantitative analysis along with its latest market trends. The market is segmented based on services type, demand determinants and geography.

Research Period  2017-2027
Base Year 2018
Forecast Period  2019-2027
Historical Year  2017
Unit  USD Billion

 By Services (2016–2026; US$ Bn)
 • Specialty pharmacy services
 • Benefit plan design and consultation
 • Drug formulary management
 • Other Services

 By Demand Determinants (2016–2026; US$ Bn)
 • Government Health Programs
 • Employer-sponsored Programs
 • Health Insurance Management

 Geography Segment (2016–2026; US$ Bn)
 • North America (U.S., Canada)
 • Europe (U.K., Germany, Rest of Europe)
 • Asia Pacific (China, Japan, Rest of APAC)
 • Latin America (Brazil, Mexico, Rest of Latin America)
 • Middle East and Africa (GCC, Rest of Middle East and Africa)

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.  

Pharmacy Benefit Management Market

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Key questions answered in this report

  • How the global pharmacy benefit management market will perform during the forecast period from 2018 to 2026?
  • What are the latest trends in the pharmacy benefit management market and valuable opportunities for key players?
  • Who are the leading players in the global pharmacy benefit management market?
  • Which is the leading and fastest region in the global pharmacy benefit management market?
  • What are drivers and restrains governing the global pharmacy benefit management market?
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Published Date:  Mar 2019
Category:  Pharmaceuticals
Report ID:   59632
Report Format:   PDF
Pages:   120
Rating:    4.2 (56)
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