Pharmacy Benefit Management [PBM] Market to Hit USD 825.92 Billion by 2030 owing to Increasing Chronic Diseases and Shift towards Value-Based Care | Research by SNS Insider

According to SNS Insider’s research, the pharmacy benefit management market is witnessing unprecedented growth, fueled by a combination of economic, technological, and healthcare trends.

Pune, Jan. 12, 2024 (GLOBE NEWSWIRE) — The SNS Insider report indicates that the size for Pharmacy Benefit Management Market was projected to be USD 522.12 billion in 2022, with an anticipated increase to USD 825.92 billion by 2030, reflecting a compound annual growth rate (CAGR) of 5.9% over the forecast period from 2023 to 2030.

Market Overview

At its core, Pharmacy Benefit Management refers to the third-party administration of prescription drug programs. PBMs act as intermediaries between insurance companies, pharmacies, and pharmaceutical manufacturers to facilitate the efficient and cost-effective delivery of prescription medications to patients. Their multifaceted role encompasses formulary management, claims processing, patient education, and negotiation with drug manufacturers to secure favorable pricing.

Market Analysis

As the global healthcare landscape grapples with escalating costs, the demand for cost-effective solutions intensifies. PBMs, by negotiating favorable drug prices and optimizing medication use, emerge as crucial players in the quest for financial sustainability in healthcare. The integration of advanced technologies, such as artificial intelligence and data analytics, empowers PBMs to enhance their operational efficiency. Automation of processes, predictive analytics, and real-time data insights contribute to more informed decision-making and improved patient care. The prevalence of chronic diseases necessitates a focus on long-term medication management. PBMs, with their expertise in formulary design and medication adherence programs, are positioned to address the growing demand for effective management of chronic conditions. The healthcare industry’s transition towards a value-based care model emphasizes positive patient outcomes. PBMs, through their commitment to optimizing medication therapies and ensuring adherence, align with the overarching goals of value-based care initiatives. All of these factors to boost the overall growth of the pharmacy benefit management market.

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Major Players Listed in this Report are:

  • Abarca Health LLC
  • CVS Health
  • Express Scripts
  • Humana Pharmacy Solutions
  • Magellan Rx Management
  • Anthem Inc.
  • McKesson Corporation
  • Medimpact Healthcare
  • MeridianRx
  • OptumRx (UnitedHealth)
  • Prime Therapeutics
  • Sea Rainbow
  • Vidalink
  • Centene Corporation & Other Players

Pharmacy Benefit Management Market Report Scope:

Report Attributes Details
Market Size in 2022  US$ 522.12 Billion
Market Size by 2030  US$ 825.92 Billion
CAGR  CAGR of 5.9% From 2023 to 2030
Base Year  2022
Forecast Period  2023-2030
Historical Data  2019-2021
Key Regional Coverage North America (US, Canada, Mexico), Europe (Eastern Europe [Poland, Romania, Hungary, Turkey, Rest of Eastern Europe] Western Europe] Germany, France, UK, Italy, Spain, Netherlands, Switzerland, Austria, Rest of Western Europe]), Asia Pacific (China, India, Japan, South Korea, Vietnam, Singapore, Australia, Rest of Asia Pacific), Middle East & Africa (Middle East [UAE, Egypt, Saudi Arabia, Qatar, Rest of Middle East], Africa [Nigeria, South Africa, Rest of Africa], Latin America (Brazil, Argentina, Colombia Rest of Latin America)

Key Takeaway from Pharmacy Benefit Management Market Study

  • The Retail Pharmacy Services segment stands out as a major player in the PBM market, wielding substantial influence over the distribution of pharmaceuticals. With the rising importance of community-based healthcare and patient-centric services, retail pharmacies have become integral components of the healthcare ecosystem.
  • The Healthcare Providers segment is emerging as a dominant force in the pharmacy benefit management market, as healthcare organizations recognize the pivotal role they play in the continuum of care. PBMs are collaborating with healthcare providers to streamline medication management processes, enhance care coordination, and optimize treatment outcomes.

Recent Developments

  • Ginkgo Bioworks and Sumitomo Chemical have officially announced an expanded partnership. The collaboration aims to propel the development of functional chemicals through innovative synthetic biology techniques.
  • In a move set to redefine the landscape of synthetic biology, GenScript is poised to debut an extensive expansion of its product line. The company, known for its pioneering contributions to the field of genetic engineering and synthetic biology, is gearing up to showcase a diverse array of innovative products.

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Market Dynamics Analysis

The dynamics of the pharmacy benefit management market are intricately woven into the fabric of the healthcare industry, experiencing a profound impact from a confluence of drivers, restraints, challenges, and threats. On the positive side, the escalating demand for cost-effective healthcare solutions acts as a key driver, propelling the PBM market forward. PBMs play a pivotal role in optimizing drug costs, streamlining prescription processes, and negotiating with pharmaceutical manufacturers, thereby offering significant cost savings for both patients and payers. Additionally, the growing prevalence of chronic diseases and the aging global population contribute to the increasing need for efficient and affordable pharmaceutical services, further fueling the growth of the PBM sector. However, the landscape is not without its challenges and restraints. Regulatory complexities, including evolving healthcare policies and stringent government regulations, pose substantial hurdles for PBMs. Navigating through the intricate web of compliance and adapting to the ever-changing regulatory environment demands a proactive approach from industry players.

Pharmacy Benefit Management Market Segmentation:

By Service

  • Retail pharmacy services
  • Specialty pharmacy services
  • Benefit plan design & consultation
  • Others

By End User

  • Healthcare Providers
  • Employers

Key Regional Developments

In North America, the pharmacy benefit management market is characterized by a mature and well-established landscape. The United States, in particular, dominates the region, accounting for a substantial share of the market. The presence of key market players, a robust healthcare infrastructure, and a high prevalence of chronic diseases contribute to the market’s growth. However, the region faces challenges such as increasing healthcare costs and evolving regulatory landscapes, influencing PBM strategies and service offerings. The European PBM market is witnessing dynamic changes as healthcare systems across the continent undergo reforms. Countries like the United Kingdom, Germany, and France are adopting PBM services to enhance the efficiency of prescription drug management.

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Impact of Recession on Pharmacy Benefit Management Market Growth

The ongoing recession has multifaceted implications for the pharmacy benefit management market. From changes in drug utilization patterns to challenges in negotiating drug prices, PBMs must deal with a complex landscape. By embracing innovation, adapting to evolving healthcare trends, and addressing the concerns of an economically strained population, pharmacy benefit managers can position themselves to weather the challenges and emerge stronger in the post-recession era.

Table of Contents – Major Key Points

1. Introduction

2. Research Methodology

3. Market Dynamics

4. Impact Analysis
4.1 Impact of the Russia-Ukraine War
4.2 Impact of Ongoing Recession
4.2.1 Introduction
4.2.2 Impact on major economies
4.2.2.1 US
4.2.2.2 Canada
4.2.2.3 Germany
4.2.2.4 France
4.2.2.5 United Kingdom
4.2.2.6 China
4.2.2.7 Japan
4.2.2.8 South Korea
4.2.2.9 Rest of the World

5. Value Chain Analysis

6. Porter’s 5 forces model

7. PEST Analysis

8. Pharmacy Benefit Management Market Segmentation, By Service

9. Pharmacy Benefit Management Market Segmentation, By End User

10. Regional Analysis

11. Company Profile

12. Competitive Landscape
12.1 Competitive Benchmarking
12.2 Market Share Analysis
12.3 Recent Developments
12.3.1 Industry News
12.3.2 Company News
12.3.3 Mergers & Acquisitions

13. USE Cases and Best Practices

14. Conclusion

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