According to the latest research report, the US pharmacy benefit management market is growing at a CAGR of 5.56% during 2023-2029.
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The U.S. Pharmacy Benefit Management Market Report Scope
Report Attributes
Details
Market Size (2029)
$680 Billion
CAGR (2023-2029)
5.56%
Historic Year
2020-2022
Base Year
2023
Forecast Year
2024-2029
The US is the largest global pharmacy benefit management market revenue contributor. The demand for the pharmacy benefit management market is rising due to multiple factors, including the rising baby boomers, the rising aging population, the increase in healthcare expenditure, the growing prevalence of heart diseases and nerve disorders, and the growing awareness among the general population. In 2023, the commercial health plans segment by health plans dominated the pharmacy benefit management market with 57.81% occupancy and is expected to grow at a CAGR of 5.29% during the forecast period as the commercial health plans are associated with the number of healthcare organizations. The Medicare plan segment is the fastest-growing segment and is expected to generate a revenue of $225.32 billion by the end of the forecasting period.
The south region dominated the segment with 29.66% in 2023 and is expected to occupy 30.65% by the end of the forecasting year. This region is the fastest growing, with an absolute growth of 43.02% and incremental growth of $62.76 billion during the forecast period. It is observed that southern states have the highest number of adults who skip care due to the cost and some of the highest rates of uninsured people. Kentucky, West Virginia, Virginia, and Louisiana are the top states with a high percentage of insurers among the southern states in the US. It is observed that 90% of the total population is insured by government or non-government firms.
The U.S. pharmacy benefit management (PBM) market report includes exclusive data on 27 vendors. CVS Health, Cigna Healthcare, United Health Group, Prime Therapeutics, MedImpact, and Humana dominate the U.S. Pharmacy Benefit Management market. The major players focus on strategic acquisitions and collaborations with emerging players to enter the pharmacy benefit management market and gain a competitive advantage.
Product Segmentation & Forecast
Health Plan
Commercial Health Plans
Medicare Plan
Medicaid Plan
Others
Business Model
Insurance Companies & Retail Pharmacies
Pure Play PBMs
Service
Special Pharmacy Services
Retail Pharmacy Networks
Mail-order pharmacy services
Claims Processing
Formulary Management
Drug Utilization Review
Price, Discount & Rebate Negotiations
Disease Management & Adherence Initiatives
Region
Unites States
South
Mid-West
West
Northeast
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Vendors List
Key Vendors
CVS Health
Cigna Healthcare
UnitedHealth Group
Prime Therapeutics
MedImpact
Humana
Abarca
Elevance Health
AscellaHealth
CaptureRx
Centene
Change Healthcare
CitizensRx
Elixir
MedalistRx
MaxorPlus
Navitus Health Solutions
PerformRx
WellDyne
ProCare Rx
NirvanaHealth
Anthem
BeneCard PBM
Shields Health Solutions
MagellanRx Management
Walgreens Boots Alliance
RITE AID
Key Questions Answered in the Report
How big is the U.S. pharmacy benefit management market?
What is the growth rate of the U.S. pharmacy benefit management market?
Who are the dominating players in the U.S. pharmacy benefit management market?
Table of Content
CHAPTER – 1: Pharmacy Benefit Management Market Overview
Executive Summary
Key Findings
CHAPTER – 2: Pharmacy Benefit Management Market
US: Projected Revenue of Pharmacy Benefit Management Market (2020-2029; $Billions)
CHAPTER – 3: Pharmacy Benefit Management Market Segmentation Data
US: Projected Revenue by Health Plan (2020-2029; $Billions)
U.S.: Projected Revenue by Business Model (2020-2029; $Billions)
US: Projected Revenue by Services (2020-2029; $Billions)
Mail-Order Pharmacy Services
Disease Management and Adherence Initiatives
U.S.: Projected Revenue by Region (2020-2029; $Billions)
South Region
Mid-West Region
West Region
Northeast Region
CHAPTER – 4: Pharmacy Benefit Management Market Prospects & Opportunities
Pharmacy Benefit Management Market Opportunities & Trends
Pharmacy Benefit Management Market Drivers
Pharmacy Benefit Management Market Constraints
CHAPTER – 5: Pharmacy Benefit Management Industry Overview
Pharmacy Benefit Management Market – Competitive Landscape
Pharmacy Benefit Management Market – Key Vendor Profiles
Pharmacy Benefit Management Market – Other Prominent Vendors
Pharmacy Benefit Management Market – Key Strategic Recommendations
CHAPTER – 6: Appendix
Research Methodology
Abbreviations
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