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Picture of health: Total health expenditure will increase, fostering industry revenue growth



Pharmacy Benefit Management

Historically, pharmacy benefit managers (PBMs) have served as third-party administrators of prescription drug programs. Today, the role of PBMs have expanded to include programs that help control prescription costs, such as offering drug formularies that feature lower cost therapeutic categories. Rising drug prices, particularly specialty drugs, have incited health insurers to turn to PBMs for cost management services. Due to the patent cliff in 2012, which caused many brand-name drugs to lose their patent exclusivity, more consumers have purchased lower-priced generic drugs. Overall, the patent cliff has benefited the industry due to PBMs typically reporting financial gains when an influx of generics come off of manufacturers’ drug pipelines. Over the five years to 2021, some PBMs will focus on expanding their ancillary product offerings by including patient counseling services.


This industry includes operators that provide pharmacy benefit management services. Industry operators are third-party administrators of government and employer-sponsored prescription drug programs. They are primarily responsible for processing and paying prescription drug claims.

This report covers the scope, size, disposition and growth of the industry including the key sensitivities and success factors. Also included are five year industry forecasts, growth rates and an analysis of the industry key players and their market shares.



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Table Of Contents

Pharmacy Benefit Management - Industry Market Research Report

TABLE OF CONTENTS

ABOUT THIS INDUSTRY
Industry Definition
Main Activities
Similar Industries
Additional Resources

INDUSTRY AT A GLANCE

INDUSTRY PERFORMANCE
Executive Summary
Key External Drivers
Current Performance
Industry Outlook
Industry Life Cycle

PRODUCTS and MARKETS
Supply Chain
Products and Services
Demand Determinants
Major Markets
International Trade
Business Locations

COMPETITIVE LANDSCAPE
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Basis of Competition
Barriers to Entry
Industry Globalization

MAJOR COMPANIES

OPERATING CONDITIONS
Capital Intensity
Technology and Systems
Revenue Volatility
Regulation and Policy
Industry Assistance

KEY STATISTICS
Industry Data
Annual Change
Key Ratios

JARGON and GLOSSARY



MAJOR COMPANIES

CVS Health Corporation

UnitedHealth Group Inc.

Express Scripts Holding Company

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