The Latest Pbm Industry Statistics Explained
The pharmacy benefit management (PBM) market size was valued at USD 502.5 billion in 2018.
The statistic that the pharmacy benefit management (PBM) market size was valued at USD 502.5 billion in 2018 indicates the total monetary value of the PBM industry for that particular year. This figure represents the revenue generated by PBMs from various services such as administering prescription drug programs, negotiating drug prices with manufacturers, and processing claims for health insurers and patients. The substantial market size highlights the significant role that PBMs play in the healthcare system, serving as intermediaries that aim to reduce drug costs, improve medication adherence, and enhance overall health outcomes for patients. Tracking the market size over time can provide insights into the financial health and growth trends of the PBM industry.
The PBM industry is expected to grow at a compound annual growth rate (CAGR) of 7.6% from 2020 to 2027.
This statistic means that the Pharmacy Benefit Management (PBM) industry is projected to experience a consistent annual growth rate of 7.6% over the period from 2020 to 2027. The compound annual growth rate (CAGR) provides a measure of the average annual growth rate of an investment over a specified period, assuming that the growth happens at a steady rate. In the context of the PBM industry, this statistic suggests that the market is expected to expand steadily in the upcoming years, presenting opportunities for growth and development within the sector. This information can be valuable for industry stakeholders, investors, and policymakers to make informed decisions and strategies based on the projected growth trajectory.
Up to 95% of US pharmacies contract with PBMs.
This statistic indicates that a significant majority, potentially up to 95%, of pharmacies in the United States have formal contractual relationships with Pharmacy Benefit Managers (PBMs). PBMs act as intermediaries between pharmacies, insurance companies, and drug manufacturers to manage prescription drug claims and pricing. By contracting with PBMs, pharmacies can gain access to a larger network of patients with insurance coverage, streamline reimbursement processes, and potentially benefit from negotiated pricing agreements. This statistic highlights the widespread influence and integration of PBMs within the U.S. healthcare system, underscoring their pivotal role in the pharmaceutical supply chain.
North America accounted for 48% share of the PBM market in 2019.
The statistic “North America accounted for 48% share of the PBM market in 2019” means that the North American region, including countries such as the United States and Canada, held a significant portion of the market for Pharmacy Benefit Management (PBM) services in the year 2019. Specifically, nearly half of the global market for PBMs was concentrated in North America during that period. This indicates that the region likely has a strong presence of PBM companies, healthcare providers utilizing PBM services, and/or a high demand for pharmaceutical cost management solutions. Understanding regional market shares in industries like PBM can provide valuable insights into market dynamics, competitive landscapes, and potential growth opportunities for businesses operating in that sector.
PBMs serve over 266 million Americans.
The statistic “PBMs serve over 266 million Americans” indicates that Pharmacy Benefit Managers (PBMs) provide services related to managing prescription drug benefits for a large proportion of the U.S. population. PBMs are third-party administrators that work with health insurance plans to negotiate drug prices, manage formularies, process prescription claims, and implement cost-saving strategies. Serving over 266 million Americans suggests that PBMs play a critical role in facilitating access to affordable medications and optimizing drug therapy outcomes for a vast majority of the country’s residents. This statistic highlights the widespread impact and significance of PBMs in the healthcare system in the United States.
Mail order pharmacy services sector for the PBM industry was valued at USD 155.3 billion in 2020.
The statistic indicates that the mail order pharmacy services sector within the Pharmacy Benefits Management (PBM) industry reached a total value of USD 155.3 billion in 2020. This value represents the revenue generated by mail order pharmacy services, which involve the delivery of prescription medications directly to patients’ homes through mail-order channels. The significant valuation of this sector suggests that there is a substantial demand for and utilization of mail order pharmacy services, likely driven by factors such as convenience, cost-effectiveness, and the increasing prevalence of chronic diseases requiring ongoing medication management. This statistic highlights the importance and growth potential of mail order pharmacy services within the broader healthcare industry.
Health Insurance sector accounted for the largest market share of 44% in the PBM industry in 2020.
The statistic “Health Insurance sector accounted for the largest market share of 44% in the PBM industry in 2020” indicates that within the Pharmacy Benefit Management (PBM) industry, the portion of the market controlled by health insurance companies was the highest compared to other sectors. This suggests that health insurance companies played a significant role in the management of pharmacy benefits in 2020, capturing a substantial share of the market. The data highlights the dominance and influence of the health insurance sector within the PBM industry during that time period, showcasing its importance in providing coverage and managing prescription drug benefits for individuals and organizations.
Retail pharmacy was the dominant distribution channel, accounting for 50.5% of the global market in 2019.
The statistic indicates that retail pharmacies played a significant role in the distribution of products within the global market in 2019, capturing a sizeable market share of 50.5%. This suggests that a substantial portion of products, likely pharmaceuticals or healthcare-related items, were supplied to consumers through retail pharmacy outlets. The dominance of retail pharmacies in the distribution channel emphasizes their importance in reaching end consumers and highlights the popularity and convenience of purchasing products through these traditional brick-and-mortar stores. It also suggests that retail pharmacies have a strong foothold in the market compared to other distribution channels, making them a key player in the global distribution network for the specified products.
The average PBM negotiates a discount of 31% off the list price of prescription drugs.
The statistic ‘The average pharmacy benefit manager (PBM) negotiates a discount of 31% off the list price of prescription drugs’ indicates that PBMs, which are intermediaries between insurance companies and pharmacies, successfully secure price reductions for their clients. PBMs negotiate with drug manufacturers on behalf of health plans to obtain lower prices for prescription medications. The 31% discount signifies the average percentage reduction from the initial list price of the drugs negotiated by PBMs. This statistic highlights the cost-saving abilities of PBMs in controlling the prices of prescription drugs and helping to manage healthcare expenses for patients and insurance providers.
The total revenue of Express Scripts, a leading PBM, was $100.06 billion in 2018.
The statistic that the total revenue of Express Scripts, a prominent pharmacy benefit management (PBM) company, was $100.06 billion in 2018 indicates the significant scale and financial stature of the company during that year. This figure encapsulates the total amount of income generated by Express Scripts through its various operations related to managing prescription drug benefits for clients such as employers and health insurers. The substantial revenue highlights Express Scripts’ substantial market presence and impact within the healthcare industry, underlining its role as a major player in facilitating access to medications and optimizing pharmaceutical cost management for millions of individuals and organizations across the United States.
The total number of lives under CVS health’s pharmacy benefits management was 93 million in 2019.
The statistic “The total number of lives under CVS Health’s pharmacy benefits management was 93 million in 2019” refers to the population serviced by CVS Health’s pharmacy benefits management program in the year 2019. This means that 93 million individuals were covered by CVS Health’s pharmacy benefits, which could include services such as prescription drug coverage, medication management, and pharmacy network access. This statistic highlights the significant reach and impact of CVS Health in providing pharmacy-related benefits to a large portion of the population, showcasing the widespread influence and importance of the company in the healthcare industry.
The commercial sector contributed to more than 35% of the PBM market share in 2020.
The statistic states that the commercial sector accounted for over 35% of the market share in the Pharmacy Benefit Management (PBM) industry in 2020. This indicates that a significant portion of the PBM market, which involves managing prescription drug benefits for various stakeholders such as employers and health insurance companies, was driven by commercial entities such as businesses and corporations. This could suggest that the commercial sector plays a substantial role in shaping the dynamics and competitiveness of the PBM market, influencing factors such as pricing, service offerings, and overall market growth.
Implementation of rigorous government regulations will boost the PBM market in Europe.
The statistic suggests that the implementation of strict government regulations in Europe will have a positive impact on the Pharmacy Benefit Management (PBM) market in the region. Government regulations can create a more structured and regulated environment for PBMs, which may lead to increased transparency, accountability, and standardization within the industry. This can help build trust among stakeholders, improve overall efficiency, and potentially attract more investment and participation in the market. Ultimately, the implementation of rigorous government regulations is expected to drive growth and development in the PBM sector in Europe.
Over 158 million prescriptions were fulfilled via mail-order pharmacies in 2019.
The statistic that over 158 million prescriptions were fulfilled via mail-order pharmacies in 2019 indicates the substantial utilization of mail-order pharmacy services within the healthcare system. This data point suggests a growing trend towards convenience and efficiency in accessing medications, as individuals opt to have their prescriptions filled and delivered directly to their homes. The large volume of prescriptions filled through mail-order pharmacies also reflects the increasing reliance on technology and digital platforms in healthcare delivery, which can potentially improve patient adherence to medication regimens and overall health outcomes.
In 2018, the consumer out-of-pocket cost share was 14.1% and the gross cost was 85.9%.
The statistic presented indicates the distribution of healthcare costs between consumers and other payers in 2018. The consumer out-of-pocket cost share of 14.1% implies that individuals paid this portion directly for healthcare services, typically through copayments, deductibles, or coinsurance. On the other hand, the gross cost of 85.9% refers to the amount covered by other payers, such as insurance companies, government programs, and employers. This statistic highlights the significant financial burden shared by consumers in accessing healthcare services, as well as the substantial portion covered by various payment sources beyond the individual level.
CVS Health Corporation held the largest share of PBM services in the U.S. in 2018, at 30%.
The statistic indicates that CVS Health Corporation held the largest market share among Pharmacy Benefit Management (PBM) services providers in the United States in 2018, with a share of 30%. PBMs play a crucial role in the healthcare industry by managing prescription drug benefits for health insurance plans. This statistic suggests that CVS Health Corporation had a significant influence and presence in the PBM sector during that year, potentially indicating a strong market position, competitive advantage, and possibly a larger client base compared to other PBM providers in the U.S.
In 2025, the PBM market in Asia-Pacific is expected to register the highest CAGR during the forecast period.
The statistic “In 2025, the Pharmacy Benefit Management (PBM) market in Asia-Pacific is expected to register the highest Compound Annual Growth Rate (CAGR) during the forecast period” indicates that the PBM market in the Asia-Pacific region is projected to experience the fastest rate of growth compared to other regions over the specified time frame. This suggests that the demand for PBM services, which involve managing prescription drug benefits for health insurance providers, is expected to increase significantly in Asia-Pacific countries. This growth could be driven by factors such as rising healthcare expenditures, expanding health insurance coverage, and increasing adoption of PBM services to control costs and improve the quality of care. Ultimately, this statistic highlights the emerging importance and potential opportunities within the PBM market in the Asia-Pacific region in the near future.
The major players in the global PBM market include CVS Health, UnitedHealth Group, and Humana Pharmacy Solutions.
The statistic provided highlights the key players in the global pharmacy benefit management (PBM) market, which is a sector of the healthcare industry focused on administering prescription drug plans for various organizations such as health insurance companies and employers. CVS Health, UnitedHealth Group, and Humana Pharmacy Solutions are recognized as major players in this market, indicating their significant market share, scale of operations, and influence in shaping industry trends. These companies are known for their extensive networks, services, and technology solutions that support the management of prescription medications, controlling costs, and improving access to healthcare services for their clients and members. Their presence in the global PBM market underscores their strategic position and competitive advantage within the healthcare sector.
PBMs are projected to save employers, unions, government programs, and consumers $654 billion over the next decade.
This statistic indicates that Pharmacy Benefit Managers (PBMs) are expected to generate significant cost savings totaling $654 billion over the next ten years for employers, unions, government programs, and consumers. PBMs play a crucial role in negotiating drug prices, managing prescription benefits, and promoting cost-effective medication utilization. By leveraging their negotiating power and implementing strategies to enhance efficiency in the pharmaceutical supply chain, PBMs are anticipated to drive down healthcare costs and deliver substantial financial benefits to various stakeholders. The projected savings highlight the important role that PBMs play in improving access to affordable medications and reducing healthcare expenditures across different sectors.
References
0. – https://www.www.macrotrends.net
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2. – https://www.www.pcmanet.org
3. – https://www.www.pharmacytimes.com
4. – https://www.www.alliedmarketresearch.com
5. – https://www.www.grandviewresearch.com
6. – https://www.www.globenewswire.com
