SEATTLE, June 21, 2021, (MEDGADGET) — Global Pharmacy Benefit Management Market – Insights
Pharmacy benefit management (PBM) deals with administration of prescription drug programs for commercial health plans and self-insured employer plans. It also focuses on development and maintenance of pharmacy contracts, negotiation of discounts and rebates with drug manufacturers, and processing and payment of prescription drug claims. PBMs rely on various tools such as drug formulary, e-prescribing, manufacturer’s discount, pharmacy networks, mail-service pharmacies, disease management, drug utilization review, and pharmacy discount cards (for the uninsured) to manage the cost of prescription drugs and improve the customer value. Various prescription claim software/systems are available to manage these tools and the PBMs account. PBM also manage the prescription drug claims i.e. acts as a link between the payers and health insurers.
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Global Pharmacy Benefit Management Market – Drivers
Increasing prices of pharmaceutical drugs is expected to boost growth of the global pharmacy benefit management market. For instance, according to Milliman, an actuarial and consulting firm, prescription drug costs increased from 13.2% in 2001 to nearly 15.9% of the overall health spending for a family of four in 2015.
Third party administrators (TPAs) operate PBM. These TPAs act as a liaison between pharmacists, insurance providers (payers), and drug manufacturers. PBM aids in reducing drug prices through negotiations with drug manufacturers and retail pharmacies. PBM benefits patients who have enrolled in various health plans and those who are uninsured. Health plans and pharmacy benefit managers collaborate to offer drugs at low costs. Moreover, PBMs also help in management and planning the formulary as per customer needs. These advantages of PBM are also expected to boost growth of the global pharmacy benefit management market over the forecast period.
Global Pharmacy Benefit Management Market – Restraints
The demand for PBMs is expected to significantly increase, owing to development of expensive therapies for the treatment of chronic diseases such as cancer and hepatitis. However, PBM has been ineffective in controlling rapid increase in drug prices even with the presence of major players in the industry. Moreover, increasing focus of various governments to decrease drug prices such as the Affordable Care Act in the U.S. is also expected to hinder growth of the market.
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Global Pharmacy Benefit Management Market Taxonomy
On the basis of the beneficiaries, the global pharmacy benefit management market is segmented into healthcare providers, employers, and drug manufacturers. Majority of the people in the U.S. receive healthcare benefits from their employers, which has led employers to opt for PBM services.
Global Pharmacy Benefit Management Market: Regional Analysis
On the basis of region, the global pharmacy benefit management market is segmented into North America, Latin America, Europe, Asia Pacific, Middle East, and Africa. The market in North America is majorly driven by high subscribers of Medicare prescription drug program. In the U.S., pharmacy benefit managers aid in deciding whether a generic or branded product would benefit the patient. Generics have a good profit margin, which can benefit the pharmacy benefit managers/management companies. Therefore, increasing number of drugs expected to expire in the near future is also boosting growth of the market in North America. For instance, patents for around 40 blockbuster brands worth US$ 155 billion are expected to expire by 2020. The market in Europe is expected to witness similar trends over the forecast period.
Global Pharmacy Benefit Management Market: Competitive Landscape
Key players operating in the global pharmacy benefit management market include, United Health / OptumRx, Catamaran Corporation, Express Scripts, CVS Caremark, Prime Therapeutics, Humana Pharmacy Solutions, and MedImpact.
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Key players in the market are focused on adopting M&A strategies to expand their product portfolio. For instance, in April 2012, Express Scripts acquired Medco Health Solutions for US$ 29.1 billion.
Major players are also focused on launching new pharmacy benefit programs to expand their product portfolio. For instance, in August 2019, Accredo, a specialty pharmacy, started a new, full-service pharmacy for residents of Hawaii who require additional clinical and administrative support for their complex treatments and medications. In July 2019, Aetna, a CVS Health company, started offering fully insured health care network options to its Preferred Product Organization (PPO), Exclusive Product Organization (EPO), and Health Maintenance Organization (HMO) product portfolios through Aetna Whole HealthSM – Southern California. In April 2019, Express Scripts, a pharmacy benefit management company, and Appriss Health, provider of prescription drug monitoring platform, developed a Prescription Drug Monitoring Program (PDMP) for the Military Health System (MHS).
Table of Content
Global Pharmacy Benefit Management Market Research Report
Section 1: Global Pharmacy Benefit Management Industry Overview
Section 2: Global Economic Impact on Pharmacy Benefit Management Industry
Section 3: Global Market Competition by Industry Producers
Section 4: Global Productions, Revenue (Value), according to Regions
Section 5: Global Supplies (Production), Consumption, Export, Import, geographically
Section 6: Global Productions, Revenue (Value), Price Trend, Product Type
Section 7: Global Market Analysis, on the basis of Application
Section 8: Pharmacy Benefit Management Market Pricing Analysis
Section 9: Market Chain, Sourcing Strategy and Downstream Buyers
Section 10: Strategies and key policies by Distributors/Suppliers/Traders
Section 11: Key Marketing Strategy Analysis, by Market Vendors
Section 12: Market Effect Factors Analysis
Section 13: Global Pharmacy Benefit Management Market Forecast
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