Pharmacy Benefit Manager (PBM) Market in the US 2015-2019

What is a pharmacy benefit manager?

A pharmacy benefit manager (PBM) is a third party administrator of prescription drug programs in the US. They can be privately funded or an integral part of a healthcare company and government health programs. PBMs are primarily responsible for the development of formularies, discounts with drug manufacturers, and pharmacy contracts, and play a significant role in the processing the payment of prescription drug claims. Their principal function is to maintain the exceeding pharmaceutical expenditures and provide improved and effective health benefits to end-users.

Market outlook of the PBM market

Technavio’s market research analyst predicts the PBM market in the US to grow at a rate of 7% during the forecast period. The increase in healthcare expenditure has propelled the demand for PBM services in the US. The US national healthcare expenditure is expected to reach USD 4 trillion by 2019. Also, about 14.4% of the US population is above 65 years of age. The healthcare expenses are especially high for senior citizens as they tend to buy pharmacy benefit plans as a precautionary measure. This, in turn, has boosted the growth of the PBM market.

Competitive landscape and key vendors

The research report predicts the competitive environment in the PBM market to intensify during the forecast period with an increase in product/service extensions and acquisitions. The market would witness the inorganic growth of vendors as a result of mergers.

The top five vendors in the market are –

• Catamaran
• CVS Health
• Express Scripts
• OptumRX
• Prime Therapeutics

Other prominent vendors in the market include Aetna, Argus Health, Centene, Cigna, Humana, MedImpact, and Rite Aid.

Growth drivers, challenges, and upcoming trends: Growth of specialty drugs market

The specialty drugs market in the US was valued at USD 85 billion during 2014 and is expected to grow tremendously at a rate of around 18% during the forecast period. Specialty drugs prove effective in the treatment complex chronic diseases like cancer, rheumatoid arthritis, multiple sclerosis, Hepatitis C, and others. These drugs need to properly prescribed and administered either by a physician or by a PBM. As these drugs are expensive, they provide a high potential growth opportunity for pharmacy retailers.

This research report provides a number of factors contributing to the adoption, limitations, and opportunities of the PBM market in the US. It also offers an analysis of each factor and an estimation of the extent to which the factors are likely to impact the overall market growth.

Key questions answered in the report include

What will the market size and the growth rate be in 2019?
What are the key factors driving the PBM market in the US?
What are the key market trends impacting the growth of the PBM market in the US?
What are the challenges to market growth?
Who are the key vendors in this market space?
What are the market opportunities and threats faced by the vendors in the PBM market in the US?
What are the key outcomes of the five forces analysis of the PBM market in the US?

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