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Pharmacy Benefit Management Market

Pharmacy Benefit Management Market - Size,
Share, Growth, Outlook, and Opportunity
Analysis, 2018-2026
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.
According to Milliman, an actuarial and consulting firm, prescription drug costs increased from 13.2%
in 2001 to nearly 15.9% of the overall health spending for a family of four 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, eprescribing, 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.
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.
Report includes chapters which deeply display the following deliverable about industry :
• Pharmacy Benefit Management Market Research Objective and Assumption
• Pharmacy Benefit Management Market Purview - Report Description, Executive Summary, and
Coherent Opportunity Map (COM)
• Pharmacy Benefit Management Market Dynamics, Regulations, and Trends Analysis - Market
Dynamics, Regulatory Scenario, Industry Trend, Merger and Acquisitions, New system
Launch/Approvals, Value Chain Analysis, Porter’s Analysis, and PEST Analysis
• Global Pharmacy Benefit Management Market, By Regions
• Pharmacy Benefit Management Market Competition by Manufacturers including Production, Share,
Revenue, Average Price, Manufacturing Base Distribution, Sales Area and Product Type.
• Pharmacy Benefit Management Market Manufacturers Profiles/Analysis including Company Basic
Information, Manufacturing Base and Its Competitors.
• Pharmacy Benefit Management Market Manufacturing Cost Analysis including Key Raw Materials
and Key Suppliers of Raw Materials.
• Industrial Chain, Sourcing Strategy and Downstream Buyers including Upstream Raw Materials
Sourcing and Downstream Buyers
• Marketing Strategy Analysis, Distributors/Traders including Marketing Channel, Market Positioning
and Distributors/Traders List.
• Market Effect Factors Analysis including Technology Progress/Risk, Consumer Needs/Customer
Preference Change and Economic/Political Environmental Change.
• Pharmacy Benefit Management Market Forecast including Production, Consumption, Import and
Export Forecast by Type, Applications and Region.
• Research Findings and Conclusion
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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