Pharmacy Benefit Management Market - Industry Analysis, Size, Share, Growth, Trends and Forecast to 2024

PHARMACY BENEFIT
MANAGEMENT MARKET
Global Industry Insights, Trends, Outlook, and
Opportunity Analysis, 2016–2024
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REPORT DESCRIPTION
Pharmacy Benefit Management Market Overview
Pharmaceutical drug prices continue soaring up and contribute significantly to total healthcare
expenditure worldwide. The cost of drugs has risen more than any of the healthcare
expenditure. As per the insurance consultants at Milliman, drug costs were merely 16% of the
overall health costs in 2015, which rose by 102% over a decade and accounted for around 14%
in 2015. Rising drug prices and increasing consumer spending on prescription drugs drives
demand for pharmacy benefit managers (PBMs). The pharmacy benefit management system is
operated by third party administrators (TPAs) who act as a liaison between pharmacists,
insurance providers (payers), and drug manufacturers. There are established companies offering
these services who aid in reducing drug prices by negotiating with retail pharmacies and drug
manufacturers. Patients who have enrolled in various health plans and those uninsured can get
the benefits of pharmacy benefit management system. Health plans collaborate with the
pharmacy benefit managers to offer medications at a lower price than those available at retail
pharmacies.
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Moreover, PBMs also aid in planning and managing the formulary as per customer needs,
negotiating discounts and rebates with drug manufacturers, contracting with pharmacies, and
processing the prescription claims. To manage the cost of prescription drugs and improve the
customer value, PBMs use various tools such as pharmacy networks, mail-service pharmacies,
drug formulary, e-prescribing, manufacturer’s discount, disease management, drug utilization
review, and pharmacy discount cards (for the uninsured). To manage these tools and the PBMs
account, there are various prescription claim software/systems marketed worldwide.
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REPORT DESCRIPTION
Pharmacy Benefit Management Market Taxonomy
The global pharmacy benefit management market can be analyzed on the basis of the beneficiaries of
these services i.e. the healthcare providers, employers, and drug manufacturers. A major population in
the U.S. receives healthcare benefits from their employers. Therefore, employers are also seeking to
reduce their costs and opt for pharmacy benefit management services. The providers of pharmacy
benefit management services also manage the prescription drug claims i.e. act as a link between the
payers and health insurers.
The Pharmacy Benefit Management Market is Highly Concentrated in Developed Markets
The global market in pharmacy benefit management is analyzed across five major regions - North
America, Europe, Asia Pacific, Latin America, Middle East, and Africa. Presence of PBM is concentrated in
the developed economies of North America and Europe. Increase in subscribers of Medicare
prescription drug program is projected to fuel demand for PBMs in the U.S. Besides, the pharmacy
benefit managers also aid in deciding whether a generic or branded product would benefit the patient.
Patents for around 40 blockbuster brands worth US$ 155 billion are expected to expire by 2020.
Generics have a good profit margin, which can benefit the pharmacy benefit managers/management
companies, thus favorably shaping the pharmacy benefit management market outlook. Similar scenario
is observed in the Europe pharmacy benefit management industry.
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Challenges faced in the Pharmacy Benefit Management Market
With the introduction of expensive treatments/drugs for chronic diseases such as cancer, and
hepatitis, demand for PBMs is projected to increase significantly. However, even with the presence of
major players in this industry, the PBMs have been ineffective in curbing the drug price hike. Further,
with the advent of Affordable Care Act and the constant endeavor of governments to reduce and cap
the drug prices, profitability of this industry is expected to be significantly impacted in the near future.
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Some of the major players present in the global pharmacy benefit management market
include Express Scripts, CVS Caremark, Prime Therapeutics, United Health / OptumRx,
Catamaran Corporation, Humana Pharmacy Solutions and MedImpact. Express Scripts
acquired Medco Health Solutions for US$ 29.1 billion in April 2012, making it a leader with a
significant share in the global pharmacy benefit management industry. With increasing
competition, industry consolidation is expected to be a prevalent trend in the near future.
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Pharmaceutical drug prices continue soaring up and contribute significantly to total healthcare expenditure worldwide. The cost of drugs has risen more than any of the healthcare expenditure. As per the insurance consultants at Milliman, drug costs were merely 16% of the overall health costs in 2015, which rose by 102% over a decade and accounted for around 14% in 2015. Rising drug prices and increasing consumer spending on prescription drugs drives demand for pharmacy benefit managers (PBMs). The pharmacy benefit management system is operated by third party administrators (TPAs) who act as a liaison between pharmacists, insurance providers (payers), and drug manufacturers. There are established companies offering these services who aid in reducing drug prices by negotiating with retail pharmacies and drug manufacturers. Patients who have enrolled in various health plans and those uninsured can get the benefits of pharmacy benefit management system. Health plans collaborate with the pharmacy benefit managers to offer medications at a lower price than those available at retail pharmacies. Request Sample Copy of the Business Report: https://www.coherentmarketinsights.com/insight/request-sample/62