Pharmacy Benefit Management Services Market Size Worth USD 657.5 Billion by 2030 at 5.56% CAGR – Report by Market Research Future (MRFR)

Pharmacy Benefit Management Services Market Trends and Insights By Service (Retail pharmacy services, Specialty pharmacy services, Benefit plan design & consultation, and Others), By End User (Healthcare Providers and Employers), And By Region (Europe, North America, Asia-Pacific, And Rest Of The World), Competitive Market Growth, Size, Share and Forecast to 2030

New York, USA, May 08, 2023 (GLOBE NEWSWIRE) -- Pharmacy Benefit Management Services Market Overview

According to a Comprehensive Research Report by Market Research Future (MRFR),  “Pharmacy Benefit Management Services Market Information By Service, End User, And Region - Forecast till 2030", Market Size was valued at USD 450.2 billion in 2022 and is projected to grow from USD 475.23 Billion in 2023 to USD 657.5 billion by 2030, exhibiting a compound annual growth rate (CAGR) of 5.56% during the forecast period (2023 - 2030).

Market Scope

Insurance companies, pharmacies, and drug manufacturers work with pharmacy benefit management companies. Third-party administrator pharmacy benefit manager (PBM) performs their duties. Pharmacy Benefit Management is a group of prescription drug plans that manages, oversees, and handles all healthcare matters and offers employers drug benefit plans. Additionally, it assists in lowering the cost of providing healthcare and prescription medications to employers. The cost reduction is accomplished by working with self-insured businesses and government programs, as well as by negotiating rebates with pharmaceutical manufacturers, signing agreements with drugstores, and processing, and paying prescription medication claims. The list of prescription medications published by pharmacy benefit management includes all medications covered by its benefit plans, and manufacturers are available to provide discounts.

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They bargain with drug producers and retail pharmacies to control the cost of branded and generic medications. The demand for prescription drug cost management is rising due to increasing chronic illnesses and rising healthcare costs in developed and developing nations. As a result, the demand for these kinds of services increases on the global market. The increasing use of pharmacy benefit management solutions by insurance companies, retail pharmacy chains, and pharmaceutical companies is causing the service providers' preferences to change from traditional workflow to advanced machine learning workflow. As a result, businesses can quickly fulfill mail orders, offer a streamlined supply chain, and service numerous coverage and retail pharmacy chains.

Report Scope:

Report AttributeDetails
Market Size in 2030USD  657.5 Billion
Base Year2022
Forecast Period2023-2030
Historical Data2021
Forecast UnitsValue (USD Billion)
Report CoverageRevenue Forecast, Competitive Landscape, Growth Factors, and Trends
Segments CoveredBy Services and End User
Geographies CoveredNorth America, Europe, Asia-Pacific, and Rest of the World (RoW)
Key Market DriversIncreasing global pharmaceutical expenses to drive market growth
Rising need to reduce medication errors and rapid broader implications of pharmacies

Pharmacy Benefit Management Services Market Competitive Landscape:

The prolific contenders in the pharmacy benefit management services market are:

  • Humana Pharmacy Solutions
  • Magellan Rx Management
  • McKesson Corporation
  • Medimpact Healthcare
  • MeridianRx
  • Abarca Health LLC
  • CVS Health
  • Express Scripts
  • OptumRx (UnitedHealth)
  • Prime Therapeutics
  • Sea Rainbow
  • Vidalink

Pharmacy Benefit Management Services Market Trends:

Market Drivers:

The need to reduce medication errors, the rapid regionalization of pharmacies, the rise in the population of elderly people, and an increase in labor costs are just a few of the factors driving the expected significant growth of the pharmaceutical benefit management market during the forecast period. However, resistance to pharmacy technology and strict regulatory requirements regarding client confidentiality restrain the market's expansion. On the other hand, it is anticipated that during the forecast period, increased awareness between pharmacists and healthcare providers of the cost-saving strategies and services offered by the Pharmacy Benefit Manager will present lucrative opportunities for market expansion. Recent drug price increases have also impacted healthcare spending, prompting health insurance companies to use these services more frequently.

Due to the rising incidence of chronic diseases and rising drug prices, the pharmacy benefit management market has been growing rapidly. The need for treatment options is rising as chronic diseases become more common among the world's population. Big drug manufacturers have focused their efforts on creating expensive branded drugs to treat chronic diseases as a result. As a result, pharmaceutical spending has significantly increased over the past few years. As a result, a sizable number of insurance companies rely on service suppliers to bargain with retail pharmacy components over the price of the drugs and lower the cost of the medications covered by the insurance. The growing use of these services resulted from expanding initiatives, such as expanding mail order delivery options and bolstering distribution networks in outlying areas.

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Market Restraints:

The pharmacy benefit management market is expanding due to rising drug spending and prescription filling rates around the world. However, concerns about business model transparency have always existed in pharmacy benefit management services. Rarely do insurance companies, retail pharmacy chains, or pharmaceutical companies receive information about funding sources for these services. As a result, the service providers bear a sizable portion of the cost of the drugs.

COVID 19 Analysis

A higher-than-anticipated demand was observed across all regions compared to pre-pandemic levels during the unprecedented and staggering global COVID-19 pandemic. The COVID-19 pandemic positively impacted the market for pharmacy benefit management. The revenue of major market players, however, got back to the pre-pandemic level due to the conclusion of vaccination drives in most countries and the availability of an extensive selection of medications at a lower price. Additionally, the demand for price control of prescription and over-the-counter drugs increased due to rising healthcare costs brought on by the global introduction of expensive specialized medicines and COVID-19 vaccines. Therefore, the major players' initiatives and the rising demand for specialty medications contributed to the pharmacy benefit management market's expansion during COVID-19.

Pharmacy Benefit Management Services Market Segmentation

By end user, the market includes healthcare providers and employers. By service, the market includes retail pharmacy services, specialty pharmacy services, and benefit plan design & consultation.

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Pharmacy Benefit Management Services Market Regional Insights

North America will dominate the pharmacy benefit management market throughout the forecast period. The rise in pharmacy benefit management adoption, medication mistakes, and healthcare costs are the main factors influencing the market's expansion. Leading insurance providers, pharmaceutical benefit management companies, and retail pharmacy chains are all based in the United States. Market expansion has been made possible by the US population's rising adoption of health insurance.

In the US, chronic diseases are more common than 50% of the time. Due to increasing insurance policy acceptance and high healthcare costs, the market for pharmacy benefit management is growing in North America. The number of health insurance providers in the area has significantly increased, which has fueled the expansion of the North American pharmacy benefit management market. Therefore, rising medication error rates are anticipated to increase the need for pharmacy dose management services, fueling market expansion.

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