Pharmacy Benefit Management

Pharmacies are under pressure to keep costs down, but it is impossible to control drug usage, which accounts for nearly 30% of all healthcare costs.

SEATTLE , WASHINGTON, UNITED STATES, December 13, 2021 /EINPresswire.com/ -- If you have a prescription drug plan, a pharmacy benefit manager (PBM) is an indispensable part of the plan. They handle your prescription drug benefits on your behalf. PBMs can be part of a commercial health plan, self-insured employer plan, Medicare Part D plan, or even a Federal Employees Health Benefits Program (FEHBP) or state government employee plan.

Pharmacies are under pressure to keep costs down, but it is impossible to control drug usage, which accounts for nearly 30% of all healthcare costs. By outsourcing the management of prescription drug benefits, PBMs save both time and money. With PBMs, you'll have access to a trusted partner, one that can help you control costs and deliver value. The most important element in a PBM relationship is integrity.

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Global Pharmacy Benefit Management Market: Competitive Landscape

Major players operating in the global pharmacy benefit management market include, CVS Caremark, Catamaran Corporation, Express Scripts, Humana Pharmacy Solutions, MedImpact, Prime Therapeutics, and United Health/OptumRx.

Recent Developments

Major players operating in the global pharmacy benefit management market are focused on launching new pharmacies and benefit programs to expand their market share. For instance, in August 2019, Accredo, a specialty pharmacy, started a new, full-service pharmacy for residents of Hawaii who require additional clinical and administrative support for their complex treatments and medications.

Global Pharmacy Benefit Management Market: Drivers

Increasing drug costs are expected to propel growth of the global pharmacy benefit management market over the forecast period. For instance, 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.

Moreover, expiry of blockbuster brands is also expected to aid in growth of the market. 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.

Market Trends

North America is expected to witness significant growth in the global pharmacy benefit management market, owing to launch of new products and services in the region. For instance, in July 2019, Aetna, a CVS Health company, started offering fully insured health care network options to its Preferred Product Organization (PPO), Exclusive Product Organization (EPO), and Health Maintenance Organization (HMO) product portfolios through Aetna Whole HealthSM - Southern California.

Major players operating in the global pharmacy benefit management market are focused on launching new pharmacies and benefit programs to expand their market share. For instance, in April 2019, Express Scripts, a pharmacy benefit managers, and Appriss Health, provider of prescription drug monitoring platform, developed a Prescription Drug Monitoring Program (PDMP) for the Military Health System (MHS).

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Global Pharmacy Benefit Management Market: Segmentation

By Service

Specialty Pharmacy Services
Drug Formulary Management
Benefit Plan Design and Consultation
Mail Order Service
Other Services

By Business Model

Government Health Programs
Employer-sponsored Programs
Health Insurance Management

By End User

Pharmacy Benefit Management Organization
Mail Order Pharmacies
Retail Pharmacies
Inpatient Pharmacies
Acute Care Settings
Long Term Care Facilities
Outpatient Pharmacies
Outpatient Clinics
Hospital Retail Settings

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