Pharmacy Benefit Management Market Size to Hit US$ 757.05 Bn by 2030

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New York, June 09, 2022 (GLOBE NEWSWIRE) — The global pharmacy benefit management market was valued at US$ 467.58 billion in 2021. The rapidly growing prevalence of various chronic diseases such as cancer, cardiovascular diseases, respiratory diseases, and diabetes among the global population, rising healthcare expenditure, growing adoption of healthcare insurances among the people, and rising penetration of the pharmacy benefit management service providers across the globe are the prominent factors that are expected to boost the growth of the global pharmacy benefit management market during the forecast period.

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The rising costs of the drugs leads to unaffordability among the majority of the patients. The major role of the pharmacy benefit management service providers is to reduce the prices of such drugs and make it affordable for the patients. The growing demand for the pharmacy benefit management services among the drug manufacturers, retail pharmacies, and health insurance providers is boosting the demand for the pharmacy benefit management services across the globe. The rising awareness among the people regarding the benefits of health insurances is boosting the adoption of insurance policies which is spurring the growth of the market significantly.

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

Report Highlights

  • Based on the service, the specialty pharmacies segment led the global market. This is attributed to the growing prevalence of chronic diseases and rising healthcare expenditure. The high prices of the specialty drugs are offered at low costs by the pharmacy benefit management service providers and hence led the growth of this segment in the market.
  • By service providers, the insurance companies dominated the market in 2021. The rapidly growing number of acquisitions and mergers between the pharmacy benefit managers and the insurance companies is the major factor behind the bolstering growth of this segment in the global market.

Scope of the Report

Report Attributes Details
Market Size in 2021 USD 767.58 Billion
Revenue Forecast by 2030 USD 757.05 Billion
CAGR 5.5% from 2022 to 2030
Base Year 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 Snapshot

North America dominated the global pharmacy benefit management market in 2021. The increased prevalence of chronic diseases among the US population, higher healthcare expenditure, and high penetration of the health insurance companies in US has led to the growth of the North America pharmacy benefit management market. More than half of the US population has one or more chronic diseases. Total healthcare expenditure increased to US$4.1 trillion or an increase of 9.7% in 2020 as compared to the previous year, as per the data provided by the Centers for Medicare and Medicaid Services. The US is home to the leading drug manufacturers, pharmacy benefit management service providers, and insurers. These market participants have significantly contributed to the growth of the North America pharmacy benefit management market.

Asia Pacific is witnessing an increasing prevalence of various chronic diseases and rising healthcar4e expenditure. The growing adoption of the health insurances and regulatory reforms regarding the reimbursements are some of the prominent factors driving the Asia Pacific pharmacy benefit management market. The rapidly surging penetration on the various pharmacy benefit management providers in the region is expected to have a significant impact on the growth of the market during the forecast period.

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Market Dynamics

Driver

Rising pharmaceutical expenditures

The growing prevalence of chronic diseases is increasing the demand for the various treatment options. The leading pharma manufacturers are focusing on the development branded and high cost drugs for the treatment of the diseases. The rising healthcare expenditures due to the rising prices of various OTC drugs and prescription drugs has led to the increased demand for the pharmacy benefit management service providers who act as a middlemen and reduces the costs of the drugs for the insurance companies and makes it available to the patient at affordable rates. This factor is expected to boost the demand for the pharmacy benefit managers in the forthcoming years.

Restraint

No transparency in the earnings

The rising drug spending and surging 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 the pharmacy benefit managers that are a major concern. The revenue sources of the pharmacy benefit service providers are rarely disclosed to the insurers, drug manufacturers, and the retail pharmacies. It results in a huge portion of costs of the drugs going into the pockets of the service providers. This factor is expected to reduce the adoption of these services which may hamper the market growth.

Opportunity

Rise in the adoption of Artificial intelligence

The surging adoption of the machine learning technologies in the pharmacy benefit management services is shifting the preferences of the service providers from the traditional workflow to the new and advanced workflow. This results in companies to offer streamline supply chain, quick delivery, and serve to a large number of retail pharmacies and insurers.

Challenge

Lack of insurance policies adoption

In the developing and underdeveloped economies, there is a low penetration and adoption of the healthcare insurance policies among the population owing to their low literacy rates and low awareness regarding the benefits of insurance policies. This is a major challenge that may restrict the market growth.

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Recent Development

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

Market Segmentation

By Service

  • Specialty Pharmacy Services
  • Benefit Plan Design & Administration
  • Formulary Management
  • Pharmacy Claims Processing
  • Others

By Service Provider

  • Retail Pharmacies
  • Insurance Companies
  • Standalone Pharmacy Benefit Management Providers

By Business Model

  • Government Health Programs
  • Employer-sponsored Programs
  • Health Insurance Management

By Geography

  • North America
  • Europe
  • Asia-Pacific
  • Latin America
  • Middle East & Africa (MEA)

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