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Published on : Jan 03, 2017

ALBANY, NY, Jan 03, 2017: The report, titled “ The US Pharmacy Benefit Management (PBM) Market: Industry Analysis & Outlook (2016-2020),” analyzes the factors that are expected to influence the market, positively or negatively, and also highlights some of the trends that have been emerging in the recent times. 

According to the report, PBM is a third-part administrator of prescription drug programs for commercial health plans, federal employee’s health benefit programs, and self-insured employer plans in the U.S. These managers can act as an intermediary between healthcare system and the payer, and in turn easing out the process of healthcare, which is generally very complex with many components. The report observes that thriving pharmaceutical industry, owing to the increase in the population in the U.S. and number of diseases, will also augment the demand for pharmacy benefit management market in the country. PBM’s also bring value through lower drug costs for insurers by negotiating with pharmacies and drug manufacturers.

Some of the factors driving the U.S. pharmacy benefit management market are: rise in geriatric population, increasing healthcare expenditure in the country, improving economic conditions, increasing life expectancy rate, and rising use of drugs. The report also highlights some of the trends in the market, such as increasing trend toward consumerism, growing trend of specialty drugs, increase in the medicare enrollments, drug prices trend, growth in retail prescriptions, declining claims and mail order penetration, and increasing mix of insured individual. The 83-page report also picks out some of the restraints in the market, such as high drug prices, reimbursement rate pressure, and legal regulations. Each of these factors have been analyzed in detail in the report.

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One of the key aspect of this report is the section on company profiles wherein it provides business overviews, financial overviews, and business strategies of some of the prominent names currently active in the market. These companies are Express Scripts, CVS Health, OptumRx, and Humana. The report observes that the competition is quite stiff in this market with three prominent players accounting for the lion’s share. This competition is expected to get stiffer during the forecast period due to increasing popularity of generics and biologics. Also, it has been observed by the report that the industry is witnessing frequent mergers and acquisitions, which will eventually aid to the extension of the demand in the market.

For smooth operations, a substantial amount of investment is required, including plants, properties, and equipment. Moreover, companies in this industry invest a significant amount in the development of internal-use software. This investment is primarily for healthcare information technology (HCIT) systems, which stores data and help in processing the claims online. Some industry operators, for example Catamaran, offers a number of HCIT applications to clients on a license or fee-for-service basis.

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