What Has Been The Historical And Current Growth Of The Pharmacy Benefit Management Market?
The pharmacy benefit management market has seen considerable growth due to a variety of factors.
• The market size of pharmacy benefit management has seen remarkable growth in the past few years. The market, which is set to expand from $648.75 billion in 2024 to $697.75 billion in 2025, is projected to have a compound annual growth rate (CAGR) of 7.6%.
Factors contributing to the significant growth during the historical period include the heightened emphasis on preventative care, extension of pharmacy networks, collaborations with healthcare providers, enhancement of patient outcomes, and advancements in pharmaceutical treatments.
What Is The Projected Growth And Market Size For The Pharmacy Benefit Management
The pharmacy benefit management market is expected to maintain its strong growth trajectory in upcoming years.
• The size of the pharmacy benefit management market is anticipated to experience robust expansion in the forthcoming years. By 2029, the market is projected to reach $966.8 billion, progressing at a compound annual growth rate (CAGR) of 8.5%.
This expansion during the forecast period is expected to be driven by factors such as the need for healthcare cost containment, the increase in prescription medication consumption, the broadening of health insurance coverage, compliance with regulatory reforms, and more patient-focused healthcare. Key trends likely to define the forecast period comprise value-oriented healthcare models, management of specialty medications, the incorporation of data analytics and AI, integration of telemedicine, and the burgeoning field of personalized medicine.
What Are The Key Drivers Fueling Growth In The Pharmacy Benefit Management Market?
The growth of the pharmacy benefit management market is majorly attributable to the growing number of individuals seeking insurance. With the intricate issue of rising medical costs, insurance offers a response by encompassing charges related to treatments, hospital stays, regular health screenings, and hospitalization costs. In the same vein, pharmacy benefit management (PBM) offers comprehensive healthcare items by merging medical and pharmaceutical products. This facilitates insurers with in-depth knowledge about the patients that assist them in crafting effective programs for patients. For instance, the United States Department of Health and Human Services, an executive level department in the U.S., stated that during the 2024 Open Enrollment Period there were an additional 5.1 million consumers availing insurance coverage, in contrast to the 2023 enrollment period, which denotes a rise by 31%. Hence, the escalating number of individuals getting insurance is propelling the progression of the pharmacy benefit management market.
What Are The Main Segments Of The Global 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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What Emerging Trends Are Influencing The Growth Of The Pharmacy Benefit Management Market?
Large entities within the pharmacy benefit management sector are strategically using acquisitions and partnerships for growing their market presence. These strategic deals enable firms to broaden their range of products and boost revenue. For example, in December 2022, Prime Therapeutics LLc, an American diversified pharmacy solutions firm focusing on pharmacy benefit management (PBM), purchased Magellan Rx Management for $1.35 billion. This merger combines Prime Therapeutics' PBM services with Magellan's specialized drug management expertise. The acquisition focuses on enhancing service range, making healthcare more affordable, improving patient care quality, fostering membership growth, and preserving operational autonomy. Additionally, it synchronizes with the healthcare sector's "Quadruple Aim" and seeks to construct a more robust pharmacy benefits management platform. Magellan Rx Management, headquartered in the U.S, specializes in pharmacy benefit and specialty management, offering comprehensive solutions for pharmacy and medical benefits.
Who Are the Key Players in 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.
What Is The Most Dominant Region In The Pharmacy Benefit Management Market?
North America was the largest region in the pharmacy benefit management market in 2024. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the pharmacy benefit management market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa.
