Pharmacy Benefit Management Services Market Report: Information by Service (Retail pharmacy services, Specialty pharmacy services, Benefit plan design and consultation, Others), End User (Healthcare Providers, Employers)- Forecast till 2030

Pharmacy Benefit Management Services Market Overview

The Pharmacy Benefit Management Services Market is projected to reach USD 530.52 Billion by 2030 at 5.20% CAGR during the forecast period 2022-2030.

The pharmacy benefit manager is a third-party administrator. Pharmacy benefit management holds the drug programs to administrate and handle healthcare issues. It offers drug benefit programs in the workplace. It provides employers with medical services at reduced costs. These benefits are driving the pharmacy benefit management services market.

Many factors boost the market’s demand, such as cost reduction, contracts with pharmacies, and paying prescription drug claims and self-insured companies and government programs. Pharmacy benefit management is flexible and can range from small to large. The market includes clinical programs like low-cost therapeutic alternatives, medication therapy management programs, tablet splitting, and mail order services.

Due to its beneficial properties, the market will ensure a significant growth rate in the forecast period. The demand for decreasing medication errors, the rapid growth of pharmacies, and the increased rate of geriatric population are driving the market. The higher adoption of automation systems in pharmacies enhances the market’s performance. Moreover, the awareness among the healthcare providers on cost reduction measures is bringing up huge growth opportunities for the market.

Pharmacy Benefit Management Services Market Segmentation

The global pharmacy benefit management services market has been segmented on the basis of service, end-user, and region.

On the basis of service, the market has been classified as retail pharmacy services, specialty pharmacy services, benefit plan design and consultation, drug formulary management, and others

By end user, the market has been segmented into healthcare providers, employers, drug manufacturers, and others.

The market has been segmented, by region, into the Americas, Europe, Asia-Pacific, and the Middle East & Africa. The market in the Americas has further been segmented into North America and South America, with the North American market divided into the US and Canada.

The European market has been segmented into Western Europe and Eastern Europe. Western Europe has been sub-segmented into Germany, France, the UK, Italy, Spain, and the rest of Western Europe. 

The market in Asia-Pacific has been divided into Japan, China, India, South Korea, Australia, and the rest of Asia-Pacific. The market in the Middle East & Africa has been segmented into the Middle East and Africa.

Regional Market Summary

Americas is likely to dominate the pharmacy benefit management services market during the forecast period owing to the advanced technologies, increasing number of hospitals and healthcare centers in the region, increasing healthcare spending, and a large pool of insurance protected population. According to the American hospital association, the number of healthcare centers in the US is continuously increasing, and in the year 2016 number of registered hospitals in the US was 5,534, roughly 2000 hospitals were present in a rural area, and 3000+ hospitals were operating in an urban area. Additionally, according to the Centers for Medicare & Medicaid services healthcare expenditure grew 3.9% in 2017 and reached 3.5 trillion which is USD 10,739 per person.     

The European region is expected to be the second-largest market in the global market owing to the rising prevalence of chronic disorders, adoption of advanced technology, fair per capita health expenditure, and favorable reimbursement policies. According to the survey conducted by The Organization for Economic Co-operation and Development (OECD), in the year 2017, the average per head spending on healthcare in Europe was USD 4,077.

The Asia-Pacific market is expected to hold a significant share in the pharmacy benefit management services market. The market growth in this region can be attributed to the rise in demand for advanced healthcare management services, increasing awareness of pharmacy benefit management services, rising geriatric population, and rising investments in healthcare. Also, countries such as India and China are considering the fastest growing region due to a government focused toward adopting advanced technology to improve the healthcare sector. According to united nations data, in 2016, approximately 12.4 percent of the population in the region was 60 years or older, but this is projected to increase to more than a quarter or 1.3 billion people by 2050.

The market in the Middle East & Africa is expected to account for the smallest share of the global market due to an underdeveloped healthcare sector, lack of technical knowledge, and poor medical facilities.

Key Players

Some of the key players in the global pharmacy benefit management services market are Abarca health LLC., CVS Health, Express Scripts, Humana Pharmacy Solutions, Magellan Rx Management, McKesson Corporation, Medimpact Healthcare, MeridianRx, OptumRx (UnitedHealth), Prime Therapeutics, Sea Rainbow, Vidalink, and others.

Recent Development

In May 2022

ProCare Rx, a global pharmacy benefits administrator with its affiliate, MC-Rx, manager, has declared that they realigned their family of businesses. This realignment will lead to leveraging each business's expertise and core competency to meet the customer’s needs and value for partners and constituents.

In May 2022

RxSense is a global healthcare technology company offering industry-leading solutions for pharmacy benefits. It has announced its partnership with EmsanaRx, a pharmacy benefit manager, to align large employers’ interests. This agreement will further increase transparency for employer clients; EmsanaRx has shared a partnership with RxSense to offer modern, cloud-based technology and provide access to performance data to help employers make informed purchasing decisions and efficiently alter the benefits.

Pharmacy Benefit Management Services Market, by Service

• Retail pharmacy services


• Specialty pharmacy services


• Benefit plan design and consultation


• Drug formulary management


• Others

Pharmacy Benefit Management Services Market, by End User

• Healthcare Providers


• Employers


• Drug Manufacturers


• Others

Pharmacy Benefit Management Services Market, by Region

• Americas
  
  
  
  • North America
    
    
    
    • US
    
    
    • Canada
    
    
    
    
  
  
  • Latin America
  
  
  
  

• Europe
  
  
  
  • Western Europe
    
    
    
    • Germany
    
    
    • France
    
    
    • Italy
    
    
    • Spain
    
    
    • UK
    
    
    • Rest of Western Europe
    
    
    
    
  
  
  • Eastern Europe
  
  
  
  

• Asia-Pacific
  
  
  
  • Japan
  
  
  • China
  
  
  • India
  
  
  • Australia
  
  
  • South Korea
  
  
  • Rest of Asia-Pacific
  
  
  
  

• Middle East & Africa
  
  
  
  • Middle East
  
  
  • Africa
  
  
  
  

Company Profiles   

• Abarca health LLC


• CVS Health


• Express Scripts


• Humana Pharmacy Solutions


• Magellan Rx Management


• McKesson Corporation


• Medimpact Healthcare


• MeridianRx


• OptumRx (UnitedHealth)


• Prime Therapeutics


• Sea Rainbow


• Vidalink


• Others

Intended Audience

• Pharmacy benefit management service providers


• Healthcare providers


• Research institutes and academic centers


• Contract research organizations (CROs)


• Government associations