Pharmacy Benefit Management Market Size to Reach US$757.05 Billion by 2030

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According to Precedence Research, the pharmacy benefit management market size is expected to reach approximately US$757.05 billion by 2030 and is expected to grow at a compound annual growth rate (CAGR) of 5.5% from 2022 to 2030. .

New York, June 09, 2022 (GLOBE NEWSWIRE) — The world pharmacy benefit management market was valued at US$467.58 billion in 2021. Rising prevalence of various chronic diseases such as cancer, cardiovascular disease, respiratory disease and diabetes among the global population, increasing healthcare expenditure, Growing adoption of health insurances among the population and increasing penetration of pharmacy benefit management service providers across the globe are the major factors expected to drive the growth of the global pharmacy benefit management market during the forecast period.

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Rising drug costs lead to unaffordability among the majority of patients. The primary role of pharmacy benefit management service providers is to reduce the prices of these drugs and make them affordable for patients. The growing demand for pharmacy benefit management services among drug manufacturers, retail pharmacies and health insurance providers is driving the demand for pharmacy benefit management services across the globe. Rising awareness among the population about the benefits of health insurances is boosting the adoption of insurance policies, which is driving the market growth significantly.

Moreover, the increasing penetration of online pharmacies and the growing number of acquisitions and mergers between pharmacy benefit managers and health insurance companies are contributing significantly to the growth of the global pharmacy benefit management market.

Report Highlights

  • Service based, the specialty pharmacy segment dominated the global market. This is attributed to the growing prevalence of chronic diseases and rising health care costs. The high prices of specialty drugs are offered at low prices by the pharmacy benefit management service providers and hence has driven the growth of this segment in the market.

  • By service providersinsurance companies dominated the market in 2021. The increasing number of acquisitions and mergers between pharmacy benefit managers and insurance companies is the main driver for the steady growth of this segment in the global market.

Report scope

Report attributes

Details

Market size in 2021

$767.58 billion

Revenue forecasts by 2030

$757.05 billion

CAGR

5.5% from 2022 to 2030

Year of reference

2021

forecast year

2022 to 2030

Key players

CVS Health, SS&C Technologies, Inc., Anthem Inc., Medimpact, Express Scripts Holding Company, Benecard Services, LLC, CaptureRx Inc., Change Healthcare, OptumRx, Inc., Cigna

Regional overview

North America dominated the global pharmacy benefits management market in 2021. The increased prevalence of chronic diseases among the US population, rising healthcare expenditures, and high penetration of health insurance companies in the United States States have led to the growth of the North American pharmacy benefits management market. . More than half of the American population suffers from one or more chronic diseases. Total healthcare spending rose to US$4.1 trillion, a 9.7% increase in 2020 from a year earlier, according to data provided by the Centers for Medicare and Medicaid Services. The United States is home to major drug manufacturers, providers of pharmacy benefit management services, and insurers. These market players have contributed significantly to the growth of the North American pharmacy benefit management market.

The Asia-Pacific region is experiencing an increasing prevalence of various chronic diseases and an increase in healthcare expenditure. Growing adoption of health insurances and regulatory reforms regarding reimbursements are some of the major factors driving the Asia Pacific pharmacy benefit management market. The booming penetration of various pharmacy benefit management vendors in the region is expected to have a significant impact on the market growth over the forecast period.

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Market dynamics

Driver

Increase in pharmaceutical expenditure

The increasing prevalence of chronic diseases increases the demand for different treatment options. Major pharmaceutical manufacturers focus on the development of branded and expensive drugs for the treatment of diseases. Rising healthcare expenses due to rising prices of various over-the-counter drugs and prescription drugs have led to increased demand for pharmacy benefit management service providers who act as intermediaries and reduce drug costs for companies. insurance and make them available to the patient at affordable rates. This factor is expected to drive the demand for Pharmacy Benefit Managers in the coming years.

Detention

No revenue transparency

Rising drug expenditures and growing number of prescription filings are the major growth drivers of the pharmacy benefit management market. There is a transparency issue associated with the business model of Pharmacy Benefit Managers that is a major concern. Pharmacy service providers’ sources of revenue are rarely disclosed to insurers, drug manufacturers and retail pharmacies. As a result, a huge portion of drug costs goes into the pockets of service providers. This factor is expected to reduce the adoption of these services, which may hamper the growth of the market.

Opportunity

Increased adoption of artificial intelligence

The growing adoption of machine learning technologies in pharmacy benefit management services is shifting the preferences of service providers from traditional to new and advanced workflows. This allows companies to offer a streamlined supply chain, fast delivery, and service a large number of retail pharmacies and insurers.

Challenge

Lack of adoption of insurance policies

In developing and underdeveloped economies, the penetration and adoption of health insurance policies among the population is low due to their low literacy rates and low awareness of the benefits of insurance policies. This is a major challenge that may limit the growth of the market.

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Recent development

  • In January 2022, Centene Corporation announced the acquisition of Magellah Health, Inc. to provide integrated healthcare solutions with better medical outcomes at lower cost.

Market segmentation

By services

  • Specialty pharmacy services

  • Benefit plan design and administration

  • Form management

  • Processing of pharmaceutical complaints

  • Others

By service provider

By business model

  • Government health programs

  • Employer sponsored programs

  • Health insurance management

By geography

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