The U.S. Pharmacy Benefit Management Market to Reach $616.4 Billion by 2027. Increasing Adoption of E-Prescription and Mail Orders Pharmacy to Create Lucrative Opportunities in the Market - Arizton
The U.S. pharmacy benefit management market was valued at $446.2 billion in 2021 and is expected to reach $616.4 billion by 2027.
Chicago, May 16, 2022 (GLOBE NEWSWIRE) -- According to Arizton’s latest research report, the U.S. pharmacy benefit (PBM) market will grow at a CAGR of 5.5% during 2022-2027. Electronic prescribing is used in healthcare technology to improve prescribing accuracy, increase patient safety, reduce costs, and enable secure, two-way, real-time electronic connectivity between doctors and pharmacies. E-prescription provides prescribers with electronic access to medical planning forms, patient eligibility, and medication history at the time of care, and a secure means to transfer prescriptions safely and electronically to the pharmacy's computer system.
Prescribing brings many benefits to PBM and medical planning. There is a possibility that in the future, opportunities to improve substance use may arise, if the PBM or medical plan can provide feedback at the time of prescribing the patient's medical history with other prescribers.
U.S. Pharmacy Benefit Management (PBM) Market Report Scope
Report Attributes | Details | |
MARKET SIZE (2027) | $616.4 Billion | |
MARKET SIZE (2021) | $446.2 Billion | |
CAGR (2022-2027) | 5.5% | |
BASE YEAR | 2021 | |
FORECAST YEAR | 2022-2027 | |
MARKET SEGMENTS | Health Plan, Services, and Business Model | |
KEY PLAYERS | CVS Health, Cigna, UnitedHealth Group |
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Are Growing FDA Approvals of Biologics & Biosimilars Impacting the Market Growth?
Over the last two decades, biopharmaceuticals have transformed the treatment of many chronic and highly complex diseases such as autoimmune disorders, cancer, and diabetes. In addition, biosimilars, which are biological copycat medications, are expected to play a significant role in the growth of the biopharmaceuticals market, especially in the APAC region. An increase in approvals of biosimilars is expected to have a significant impact on the growth of the single-use bioprocessing market. Moreover, PBMs leverage the availability of alternatives to both biosimilars and their biological reference products as part of an overall strategy to reduce costs in the healthcare system.
Key Highlights
The presence of prominent market players, increasing favorable healthcare reforms, rising e-prescription, and growing adoption of healthcare plans by residents of the United States are the primary factors for the significant market share in the country.
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.
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.
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.
Key Offerings:
Market Size & Forecast by Volume | 2022−2028
Market Dynamics – Leading trends, growth drivers, restraints, and investment opportunities
Market Segmentation – A detailed analysis by
Competitive Landscape – 6 key vendors and 11 other vendors
Market Segmentation
Health Plan
Commercial Health Plans
Medicare
Medicaid
Others
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
Business Model
Insurance Companies and Retail Pharmacies
Pure Play PBMS
What are the Strategies Adopted by the Players in the US Pharmacy Benefit Market (PBM)?
The competitive landscape of PBM has changed considerably over the last couple of years, where acquisitions led the market and are occupied mostly by a couple of giants. There are very few recent entrants that have made a mark in the market. PBM market is expected to witness high competition and a challenging atmosphere due to increasing consumer pressure, political pressure, legal scrutiny, and due to the forces of new, innovative players. Instead of fighting over profits, manufacturers and PBMs could team up to create patient-centric solutions, that would serve growth benefits to the players.
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
Explore our healthcare lifesciences profile to know more about the industry.
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CONTACT: Arizton Advisory and Intelligence Call: +1-312-235-2040 +1 302 469 0707