According to a report,“U.S. Pharmacy Benefit Management (PBM) Market Analysis Report By Business Model (Standalone, Health Insurance Providers, Retail Pharmacy), By End Use (Commercial, Federal), And Segment Forecasts, 2019 – 2026”, published by Grand View Research, Inc., The U.S. pharmacy benefits management market size is projected to reach USD 744.6 billion by 2026, exhibiting a CAGR of 9.2% during the forecast period. Increasing vertical integration of key market players, rising prevalence of chronic disease, and shrinking FDA generic-approval backlog are some of the primary growth stimulants for the market.
Key Takeaways from the report:
Based on business model, the market has been segmented into standalone PBM, health insurance providers, and retail pharmacy. Of these, PBMs associated with health insurers are likely to witness the fastest growth over the forecast period
Rise in mergers and partnerships between market players is expected to result in an increased demand for PBM systems
OptumRx and Express Scripts (merged with Cigna in December 2018) are among the key players merged or acquired by large health insurance providers
Based on end use, the market has been divided into commercial and federal. Commercial PBM systems dominated the market and are estimated to maintain their dominance through 2026 owing to a large number of covered patients
CVS Health; Aetna; Express Scripts; Cigna; OptumRx, Inc.; Walgreens Booth Alliance; MedImpact Healthcare Systems, Inc.; Anthem; and Rite Aid are some of the key players in the market.
Browse More Reports in Healthcare IT Industry:
• Ophthalmology PACS Market: Rising prevalence of eye diseases, such as cataract, glaucoma, age-related macular degeneration, and diabetic retinopathy, is expected to fuel demand for ophthalmology PACS in near future.
• Electronic Health Records (EHR) Market : The rising demand for streamlining electronic healthcare systems along with technological advancements in the field of healthcare information technology (IT) is expected to be a key factor contributing to the health records (EHR) market growth.
Vertical integration of pharmacy benefits management (PBM) organizations with health insurance companies are poised to result in increased control of PBMs over distribution systems. This will lead to rise in rebates, ultimately increasing the cost of drug list prices. Moreover, it will result in a monopoly of certain market player, concentrating sales and revenue generation.
The business of insuring and administering employee benefit programs in the country, especially, health care programs, is heavily regulated by federal and state laws and administrative agencies, such as the Department of Health and Human Services (HHS), State Departments of Insurance, Centers for Medicare & Medicaid Services (CMS), Internal Revenue Services, and Departments of Labor.
All PBM businesses in the U.S. must include home delivery and specialty pharmacies licensed as pharmacies in the states of establishment. Several states in the country regulate the scope of prescription (Rx) drug coverage and delivery channels to receive drugs for managed care organizations (MCOs), insurers, and Medicaid care plans. Certain home delivery and specialty pharmacies must be registered with the U.S. Drug Enforcement Administration (DEA) and individual state controlled substance authorities.
Grand View Research has segmented the U.S. pharmacy benefits management (PBM) market based on business model and end use:
Business Model Outlook (Revenue, USD Billion, 2015 – 2026)
Standalone PBMs
Health Insurance Providers
Retail Pharmacy
End Use Outlook (Revenue, USD Billion, 2015 – 2026)
Commercial
Federal
Explore the U.S. pharmacy benefit management market research database, Navigate with Grand View Compass, by Grand View Research, Inc.
About Grand View Research
Grand View Research provides syndicated as well as customized research reports and consulting services on 46 industries across 25 major countries worldwide. This U.S.-based market research and consulting company is registered in California and headquartered in San Francisco. Comprising over 425 analysts and consultants, the company adds 1200+ market research reports to its extensive database each year. Supported by an interactive market intelligence platform, the team at Grand View Research guides Fortune 500 companies and prominent academic institutes in comprehending the global and regional business environment and carefully identifying future opportunities.
For more information: www.grandviewresearch.com
Media ContactCompany Name: Grand View Research, Inc.Contact Person: Sherry James, Corporate Sales Specialist – U.S.A.Email: Send EmailPhone: 1-415-349-0058, Toll Free: 1-888-202-9519Address:201, Spear Street, 1100 City: San FranciscoState: CaliforniaCountry: SwitzerlandWebsite: www.grandviewresearch.com/industry-analysis/us-pharmacy-benefit-management-pbm-market
