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How large is the pharmacy benefit management market, and what is its growth trajectory?
The pharmacy benefit management market size has grown strongly in recent years. It will grow from $648.75 billion in 2024 to $697.75 billion in 2025 at a compound annual growth rate (CAGR) of 7.6%. The growth in the historic period can be attributed to increased focus on preventative care, pharmacy network expansion, partnerships with healthcare providers, focus on patient outcomes, advancements in pharmaceutical therapies.
The pharmacy benefit management market size is expected to see strong growth in the next few years. It will grow to $966.8 billion in 2029 at a compound annual growth rate (CAGR) of 8.5%. The growth in the forecast period can be attributed to healthcare cost control demands, rise in prescription drug usage, health insurance expansion, adherence to regulatory changes, patient-centric healthcare. Major trends in the forecast period include value-based healthcare models, specialty medications management, data analytics and AI integration, telemedicine integration, rise in personalized medicine.
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Which industry factors have accelerated the pharmacy benefit management market’s expansion?
The rise in the number of people availing insurance significantly contributes to the growth of the pharmacy benefit management market. Insurance provides a solution to deal with the increased medical costs by covering the expenses related to treatment, hospitalization, health check-ups, and hospitalization expenses. Similarly, pharmacy benefit management (PBM) supports end-to-end healthcare products by combining medical as well as pharmaceutical products. This enables the insurers to have extensive information regarding the patients that helps the insurers provide efficient programs to patients. For instance, according to the United States Department of Health and Human Services is a US-based cabinet-level executive branch department of the U.S. federal government reported, 5.1 million more consumers signed up for coverage during the 2024 OEP(Open Enrollment Period) compared to the 2023 OEP (Open Enrollment Period), a 31% increase. Therefore, the rise in the number of people availing of insurance is driving the growth of the pharmacy benefit management market.
What are the primary segments of the pharmacy benefit management market?
The pharmacy benefit management market covered in this report is segmented –
1) By Services: Mail-Delivery, Specialty Pharmacy, Preferred Network Pharmacy
2) By Type: Commercial Health Plans, Self-Insured Employer Plans, Medicare Part D Plans, Federal Employees Health Benefits Program
3) By End User: Pharmacy Benefit Management Organization, Mail Order Pharmacies, Retail Pharmacies, Inpatient Pharmacies, Outpatient Pharmacies
Subsegments:
1) By Mail-Delivery: Maintenance Medications, Acute Care Medications, Patient Education And Support Services
2) By Specialty Pharmacy: High-Cost Medications, Biologics And Biosimilars, Disease Management Services
3) By Preferred Network Pharmacy: Retail Pharmacy Networks, Contracted Pharmacy Networks, Urgent Care Pharmacy Services
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Which firms are leading the pharmacy benefit management market?
Major companies operating in the pharmacy benefit management market include CVS Health Corporation, Cigna Corporation, Centene Corporation, Anthem Inc., OptumRx Inc., Humana Pharmacy Solutions Inc., Magellan Health Inc., Prime Therapeutics LLC, MaxorPlus Ltd., RxAdvance Corp, MedImpact Healthcare Systems Inc., PerformRx LLC., Navitus Health Solutions LLC, WellDyneRx Inc., Healthesystems LLC., Catalyst Rx Inc., Argus Health Systems Inc., Innoviant Pharmacy Inc., Pharmaceutical Strategies Group, ProCare Rx Inc., FutureScripts LLC., National CooperativeRx, ScriptCare Ltd., US Script Inc., LDI Integrated Pharmacy Services LLC, RxPreferred Benefits, SinfoníaRx Inc.
Which market trends are set to define the future of the pharmacy benefit management market?
Major companies in pharmacy benefit management market are focusing on acquisition and partnership deals to expand market share. Acquisition and partnership deals allow organizations to expand product portfolio and increase sales. For instance, in December 2022, Prime Therapeutics LLc, U.S-based diversified pharmacy solutions organization that focuses on pharmacy benefit management (PBM) has acquired Magellan Rx Management for $1.35 billion, combining its pharmacy benefit management (PBM) services with specialty drug management expertise. The deal aims to enhance service offerings, drive affordability, improve patient care, expand membership, and maintain operational independence. The acquisition aligns with the healthcare industry’s “Quadruple Aim” and aims to create a more robust pharmacy benefits management platform. Magellan Rx Management is U.S-based company involved in specialty and pharmacy benefit management. It provides comprehensive solutions across pharmacy and medical benefits.
Which geographic trends are shaping the pharmacy benefit management market, and which region has the highest market share?
The countries covered in the pharmacy benefit management market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA, Canada, Italy, Spain.
What Does The Pharmacy Benefit Management Market Report 2025 Offer?
The pharmacy benefit management market research report from The Business Research Company offers global market size, growth rate, regional shares, competitor analysis, detailed segments, trends, and opportunities.
Pharmacy benefit management is a collection of businesses that function as intermediaries between insurance companies, pharmacies, and drug distributors. It is used to ensure that insurers and insurance companies pay reduced prescription costs by negotiating with pharmacists and medicine producers.
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