In-Depth Insights into the Pharmacy Benefit Management Market: Growth, Trends, and Opportunities for 2025-2034
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How has the pharmacy benefit management market size evolved in recent years?
The market size of pharmacy benefit management has experienced robust expansion in the recent past. It is projected to surge from $648.75 billion in 2024 to $697.75 billion in 2025, with a compound annual growth rate (CAGR) of 7.6%. Factors contributing to this growth during the historical period include an amplified emphasis on preventative care, an expansion of the pharmacy network, collaborations with healthcare providers, concentration on patient outcomes, and progress in pharmaceutical therapies.
What are the predictions for the pharmacy benefit management market size in the coming years?
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What key factors are fueling the growth of the pharmacy benefit management market?
The pharmacy benefit management market is expanding due to a significant uptick in individuals securing insurance, a trend that effectively addresses the surge in medical costs by covering expenditures for treatments, hospital stays, health assessments, and other hospitalization-related costs. Pharmacy benefit management (PBM) complements this by offering integrated healthcare products that combine medical and pharmaceutical goods. This arrangement allows insurance providers to gather comprehensive data on patients, enabling them to develop effective programs. For example, the U.S. Department of Health and Human Services reported an increase of 5.1 million consumers enrolling for coverage during the 2024 OEP (Open Enrollment Period), a 31% increase from the 2023 OEP. Accordingly, the growing number of people securing insurance is fuelling the expansion of the pharmacy benefit management market.
How is the global pharmacy benefit management market divided into key segments?
The pharmacy benefit management market covered in this report is segmented –
1) By Services: Mail-Delivery, Specialty Pharmacy, Preferred Network Pharmacy
2) By Type: Commercial Health Plans, Self-Insured Employer Plans, Medicare Part D Plans, Federal Employees Health Benefits Program
3) By End User: Pharmacy Benefit Management Organization, Mail Order Pharmacies, Retail Pharmacies, Inpatient Pharmacies, Outpatient Pharmacies
Subsegments:
1) By Mail-Delivery: Maintenance Medications, Acute Care Medications, Patient Education And Support Services
2) By Specialty Pharmacy: High-Cost Medications, Biologics And Biosimilars, Disease Management Services
3) By Preferred Network Pharmacy: Retail Pharmacy Networks, Contracted Pharmacy Networks, Urgent Care Pharmacy Services
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Who are the key firms paving the way for growth in the pharmacy benefit management market?
Major companies operating in the pharmacy benefit management market include CVS Health Corporation, Cigna Corporation, Centene Corporation, Anthem Inc., OptumRx Inc., Humana Pharmacy Solutions Inc., Magellan Health Inc., Prime Therapeutics LLC, MaxorPlus Ltd., RxAdvance Corp, MedImpact Healthcare Systems Inc., PerformRx LLC., Navitus Health Solutions LLC, WellDyneRx Inc., Healthesystems LLC., Catalyst Rx Inc., Argus Health Systems Inc., Innoviant Pharmacy Inc., Pharmaceutical Strategies Group, ProCare Rx Inc., FutureScripts LLC., National CooperativeRx, ScriptCare Ltd., US Script Inc., LDI Integrated Pharmacy Services LLC, RxPreferred Benefits, SinfoníaRx Inc.
Which trends are expected to transform the pharmacy benefit management market?
Significant businesses in the pharmacy benefit management market encompass CVS Health Corporation, Cigna Corporation, Centene Corporation, Anthem Inc., OptumRx Inc., and Humana Pharmacy Solutions Inc., among others. Other noteworthy participants include Magellan Health Inc., Prime Therapeutics LLC, MaxorPlus Ltd., and RxAdvance Corp. Further, we also have MedImpact Healthcare Systems Inc., PerformRx LLC., Navitus Health Solutions LLC, WellDyneRx Inc., and Healthesystems LLC. Also playing significant roles are Catalyst Rx Inc., Argus Health Systems Inc., Innoviant Pharmacy Inc., and the Pharmaceutical Strategies Group. ProCare Rx Inc., FutureScripts LLC., National CooperativeRx, ScriptCare Ltd., US Script Inc., LDI Integrated Pharmacy Services LLC, RxPreferred Benefits, and SinfoníaRx Inc. are also part of this market.
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What regions are contributing significantly to the growth of the pharmacy benefit management market?
North America was the largest region in the pharmacy benefit management market in 2024. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the pharmacy benefit management market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa.
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