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Pharmacy Benefit Management - Industry Market Research Report

Pharmacy Benefit Management

Operators in the Pharmacy Benefit Management industry act as intermediaries between healthcare payers and the rest of the US healthcare system. For example, pharmacy benefit managers (PBMs) help process prescription claims, negotiate rebates, develop drug formularies and review drug utilization rates. As PBMs integrated with companies in other sectors of healthcare over the five years to 2019, the industry became more concentrated. Overall, rising total health expenditure and prescription drug use drove demand for industry services during the current period. Additionally, many brand-name drugs lost their patent exclusivity, giving more consumers access to lower-priced generic drugs. As a result, industry revenue is expected to increase during the current period. Over the five years to 2024, industy revenue is forecast to continue rising. PBMs will likely focus on expanding their ancillary product offerings, while others are expected to focus on cutting healthcare costs.

This industry includes operators that provide pharmacy benefit management services. Industry operators are third-party administrators of government and employer-sponsored prescription drug programs. They are primarily responsible for processing and paying prescription drug claims.

This report covers the scope, size, disposition and growth of the industry including the key sensitivities and success factors. Also included are five year industry forecasts, growth rates and an analysis of the industry key players and their market shares.


  • About this Industry
  • Industry at a Glance
    • Table Key Statistics Snapshot
    • Table Revenue vs. employment growth
    • Table Products and services segmentation (2019)
    • Table Industry Structure
  • Industry Performance
    • Table Total health expenditure
    • Table Industry revenue
    • Table Life Cycle Stage
  • Products & Markets
    • Table KEY BUYING INDUSTRIES
    • Table KEY SELLING INDUSTRIES
    • Table Products and services segmentation (2019)
    • Table Major market segmentation (2019)
    • Table Business Locations 2019
    • Table Distribution of establishments vs. population
  • Competitive Landscape
    • Table Sector vs. Industry Costs
    • Table Barriers to Entry checklist
  • Major Companies
    • Table Major Players
    • Table CVS Health Corporation (US industry-specific segment) - financial performance*
    • Table Express Scripts Holding Company (US industry-specific segment) - financial performance*
    • Table UnitedHealth Group Inc. (US industry-specific segment) - financial performance*
  • Operating Conditions
    • Table Capital Intensity
    • Table Tools of the Trade: Growth Strategies for Success
    • Table Volatility vs. growth
  • Key Statistics
    • Table Industry Data
    • Table Annual Change
    • Table Key Ratios
  • Jargon & Glossary

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