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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

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Published: | Report ID: 9523 | Report Format : PDF

Industry Outlook

The global pharmacy benefit management market was worth US$ 405.4 billion in 2017 and is expected to grow at a compound annual growth rate (CAGR) of 5.4% from 2018 to 2026. Pharmacy benefit managers (PBM) are an organization that provides educational programs and services to aid healthcare seekers. The PBM acts as 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 determining retail prices for pharmaceutical products, negotiating rebates from pharmaceutical manufacturers based on total product sales volume, and obtaining post-sale price discounts and reimbursements from pharmacies.PBMs use their utilization management and buying power to lower the cost of pharmaceuticals. Most payers choose to contract with PBMs rather than procure drugs internally. Commercial insurers, Medicare, and Medicaid, are the major end-users for PBMs. Moreover, PBMs are also able to influence patients to switch to less expensive brand-name drugs by playing brands off one another.

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Market Synopsis

However, criticism of the PBM model in the recent past is acting as a major restraint on the growth of the market. The Medicare Payment Advisory Commission has expressed concern about PBMs’ failure to select the lowest-cost drugs. 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, these concerns over PBM’s working model will negatively affect the market during the forecast period. In 2017, specialty pharmacy services held the largest share of the global pharmacy benefit management market. Growing market consolidation due to mergers and acquisitions in the market will boost the specialty pharmacy services market.

Periods of History and Forecast

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

Report Scope by Segments

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

The key players currently engaged in the 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.

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Key questions are answered in this report.

  • How will the global pharmacy benefit management market perform during the forecast period from 2018 to 2026?
  • What are the latest trends in the pharmacy benefit management market and the most valuable opportunities for key players?
  • Who are the leading players in the global pharmacy benefit management market?
  • Which is the leading and fastest-growing region in the global pharmacy benefit management market?
  • What are the drivers and restraints governing the global pharmacy benefit management market?

Chapter 1. Preface
1.1. Report Description
1.1.1. Study Purpose
1.1.2. Target Audience
1.1.3. USP and Key Offerings
1.2. Research Scope
1.3. Research Methodology
1.3.1. Phase I – Secondary Research
1.3.2. Phase II – Primary Research
1.3.3. Phase III – Expert Panel Review
1.3.4. Assumptions
1.4. Market Segmentation

Chapter 2. Executive Summary
2.1. Global PBM Market Portraiture
2.2. Global PBM Market, by Services, 2017 (US$ Bn)
2.3. Global PBM Market, by Business Model, 2017 (US$ Bn)
2.4. Global PBM Market, by Geography, 2017 (US$ Bn)

Chapter 3. Pharmacy Benefit Management (PBM): Market Dynamics and Outlook
3.1. Market Overview
3.2. Drivers
3.3. Challenges
3.4. Opportunities
3.5. Attractive Investment Proposition, by Geography, 2017
3.6. Competitive Analysis: Global PBM Market, by Key Players, 2017

Chapter 4. Global Pharmacy Benefit Management (PBM) Market, by Services, 2016-2026 (US$ Bn)
4.1. Overview
4.2. Specialty Pharmacy Services
4.3. Benefit Plan Design and Consultation
4.4. Drug Formulary Management
4.5. Other Services

Chapter 5. Global Pharmacy Benefit Management (PBM) Market, by Business Model, 2016-2026 (US$ Bn)
5.1. Government Health Programs
5.2. Employer-sponsored Programs
5.3. Health Insurance Management

Chapter 6. Global Pharmacy Benefit Management (PBM) Market, by Geography, 2016 – 2026 (US$ Bn)
6.1. North America PBM Market Analysis, 2016 – 2026
6.1.1. North America PBM Market, by Services Type, 2016 – 2026 (US$ Bn)
6.1.2. North America PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
6.1.3. North America PBM Market, by Country, 2016 – 2026 (US$ Bn)
6.1.3.1. U.S.
6.1.3.2. Canada
6.2. Europe PBM Market Analysis, 2016 – 2026
6.2.1. Europe PBM Market, by Services, 2016 – 2026 (US$ Bn)
6.2.2. Europe PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
6.2.3. Europe PBM Market, by Country/Region, 2016 – 2026 (US$ Bn)
6.2.3.1. U.K.
6.2.3.2. Germany
6.2.3.3. Rest of Europe
6.3. Asia Pacific PBM Market Analysis, 2016 – 2026
6.3.1. Asia Pacific PBM Market, by Services, 2016 – 2026 (US$ Bn)
6.3.2. Asia Pacific PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
6.3.3. Asia Pacific PBM Market, by Country/Region, 2016 – 2026 (US$ Bn)
6.3.3.1. China
6.3.3.2. Japan
6.3.3.3. Rest of Asia Pacific
6.4. Latin America PBM Market Analysis, 2016 – 2026
6.4.1. Latin America PBM Market, by Services, 2016 – 2026 (US$ Bn)
6.4.2. Latin America PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
6.4.3. Latin America PBM Market, by Country/Region, 2016 – 2026 (US$ Bn)
6.4.3.1. Brazil
6.4.3.2. Mexico
6.4.3.3. Rest of Latin America
6.5. Middle East & Africa PBM Market, 2016 – 2026
6.5.1. Middle East & Africa PBM Market, by Services, 2016 – 2026 (US$ Bn)
6.5.2. Middle East & Africa PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
6.5.3. Middle East & Africa PBM Market, by Region, 2016 – 2026 (US$ Bn)
6.5.3.1. GCC
6.5.3.2. Rest of Middle East & Africa

Chapter 7. Company Profiles
7.1. CVS Health
7.1.1. Business Description
7.1.2. Financial Information (Subject to Data Availability)
7.1.3. Product Portfolio
7.1.4. News Coverage
7.2. Express Scripts Holding Company
7.3. Cigna Corp.
7.4. Optumrx, Inc.
7.5. Anthem
7.6. Walgreens Boots Alliance, Inc.
7.7. Medimpact Healthcare Systems, Inc.
7.8. Rite Aid Corp
7.9. DST Systems, Inc.
7.10. Prime Therapeutics LLC

List of Figures

FIG 1. Pharmacy Benefit Management (PBM) Market: Research Methodology
FIG 2. PBM: Market Segmentation
FIG 3. Global PBM Market, by Services Type, 2017 (US$ Bn)
FIG 4. Global PBM Market, by Business Model, 2017 (US$ Bn)
FIG 5. Global PBM Market, by Geography, 2017 (US$ Bn)
FIG 6. Attractive Investment Proposition, by Geography, 2017
FIG 7. Competitive Analysis: Global PBM Market, by Key Players, 2017
FIG 8. Global Specialty Pharmacy Services Market, 2016-2026 (US$ Bn)
FIG 9. Global Benefit Plan Design and Consultation Services Market, 2016-2026 (US$ Bn)
FIG 10. Global Drug Formulary Management Services Market, 2016-2026 (US$ Bn)
FIG 11. Global Other Services Market, 2016-2026 (US$ Bn)
FIG 12. Global Government Health Programs Market, 2016-2026 (US$ Bn)
FIG 13. Global Employer-sponsored Programs Market, 2016-2026 (US$ Bn)
FIG 14. Global Health Insurance Management Market, 2016-2026 (US$ Bn)
FIG 15. U.S. PBM Market, 2016-2026 (US$ Bn)
FIG 16. Canada PBM Market, 2016-2026 (US$ Bn)
FIG 17. U.K. PBM Market, 2016-2026 (US$ Bn)
FIG 18. Germany PBM Market, 2016-2026 (US$ Bn)
FIG 19. Rest of Europe PBM Market, 2016-2026 (US$ Bn)
FIG 20. China PBM Market, 2016-2026 (US$ Bn)
FIG 21. Japan PBM Market, 2016-2026 (US$ Bn)
FIG 22. Rest of Asia Pacific PBM Market, 2016-2026 (US$ Bn)
FIG 23. Brazil PBM Market, 2016-2026 (US$ Bn)
FIG 24. Mexico PBM Market, 2016-2026 (US$ Bn)
FIG 25. Rest of Latin America PBM Market, 2016-2026 (US$ Bn)
FIG 26. GCC PBM Market, 2016-2026 (US$ Bn)
FIG 27. Rest of Middle East & Africa PBM Market, 2016-2026 (US$ Bn)

List of Tables

TABLE 1 Global Pharmacy Benefit Management (PBM) Market Portraiture
TABLE 2 Global PBM Market, by Services Type, 2017 (US$ Bn)
TABLE 3 Global PBM Market, by Business Model, 2017 (US$ Bn)
TABLE 4 Global PBM Market, by Geography, 2017 (US$ Bn)
TABLE 5 North America PBM Market, by Services Type, 2016 – 2026 (US$ Bn)
TABLE 6 North America PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
TABLE 7 North America PBM Market, by Country, 2016 – 2026 (US$ Bn)
TABLE 8 Europe PBM Market, by Services, 2016 – 2026 (US$ Bn)
TABLE 9 Europe PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
TABLE 10 Europe PBM Market, by Country/Region, 2016 – 2026 (US$ Bn)
TABLE 11 Asia Pacific PBM Market, by Services, 2016 – 2026 (US$ Bn)
TABLE 12 Asia Pacific PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
TABLE 13 Asia Pacific PBM Market, by Country/Region, 2016 – 2026 (US$ Bn)
TABLE 14 Latin America PBM Market, by Services, 2016 – 2026 (US$ Bn)
TABLE 15 Latin America PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
TABLE 16 Latin America PBM Market, by Country/Region, 2016 – 2026 (US$ Bn)
TABLE 17 Middle East & Africa PBM Market, by Services, 2016 – 2026 (US$ Bn)
TABLE 18 Middle East & Africa PBM Market, by Business Model, 2016 – 2026 (US$ Bn)
TABLE 19 Middle East & Africa PBM Market, by Region, 2016 – 2026 (US$ Bn)
TABLE 20 CVS Health: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 21 Express Scripts Holding Company: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 22 Cigna Corp.: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 23 Optumrx, Inc.: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 24 Anthem: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 25 Walgreens Boots Alliance, Inc.: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 26 Medimpact Healthcare Systems, Inc.: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 27 Rite Aid Corp: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 28 DST Systems, Inc.: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)
TABLE 29 Prime Therapeutics LLC: Company Snapshot (Business Description; Financial Information; Product Portfolio; Key Developments)

Frequently Asked Questions:

What is the size of Pharmacy Benefit Management Market?

The market for Pharmacy Benefit Management Market is expected to reach US$ 405.4 Bn by 2026.

What is the Pharmacy Benefit Management Market CAGR?

The Pharmacy Benefit Management Market is expected to see significant CAGR growth over the coming years, at 5.4%.

What is the Forecast period considered for Pharmacy Benefit Management Market?

The report is forecasted from 2018-2026.

What is the base year considered for Pharmacy Benefit Management Market?

The base year of this report is 2017.

Who are the major players in this market?

CVS Health, Express Scripts Holding Company, Cigna, Anthem, Optumrx, Inc., Walgreens Boots Alliance, Inc., and Rite Aid Corp are some of the major players in the global market.

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