Pharmacy Benefit Management Market Analysis and Forecast to 2031: By Service (Specialty Pharmacy Services, Drug Formulary Management, Mail Order Service, Others), End User (Pharmacy Benefit Management Organization, Mail Order Pharmacies, Retail Pharmacies

Pharmacy Benefit Management Market Analysis and Forecast to 2031: By Service (Specialty Pharmacy Services, Drug Formulary Management, Mail Order Service, Others), End User (Pharmacy Benefit Management Organization, Mail Order Pharmacies, Retail Pharmacies, Others), and Region

Pharmacy Benefit Management (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer groups, unions, government employee groups, and managed care organizations. PBMs are responsible for developing and maintaining the formulary, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims. They also provide drug utilization review, mail order pharmacy services, and specialty pharmacy services.

Key Trends

Pharmacy benefit management (PBM) technology is a rapidly evolving field that is constantly innovating to meet the needs of patients, providers, and payers. The following are some of the key trends in PBM technology:

1. Personalized medicine: PBMs are increasingly using data to tailor medication regimens to individual patients. This personalized approach to medicine can improve patient outcomes and reduce costs.

2. Predictive analytics: PBMs are using data to predict which patients are likely to experience adverse events or non-adherence. This allows them to intervene early and prevent problems before they occur.

3. Digital health: PBMs are incorporating digital health tools into their platforms to improve patient engagement and medication adherence. These tools include mobile apps, text messaging, and wearable devices.

4. Drug pricing transparency: PBMs are under pressure to provide more transparency around drug pricing. This includes providing patients with information on the cost of their medications and the discounts that are available.

Key Drivers

The key drivers of the pharmacy benefit management (PBM) market are the rising costs of healthcare and the increasing demand for cost-effective and efficient drug benefit programs. PBMs are third-party administrators of drug benefit programs that use their negotiating clout with drug manufacturers to obtain discounts and rebates on behalf of their clients, which include employers, health plans, government agencies, and unions. In return for these discounts, PBMs may require their clients to use a particular pharmacy or group of pharmacies, which can result in higher costs for consumers.

The rising costs of healthcare are a major driver of the PBM market. Healthcare costs have been rising steadily for years, and this trend is expected to continue. In order to control costs, employers and health plans are increasingly turning to PBMs to manage their drug benefit programs. PBMs are able to negotiate discounts with drug manufacturers that can save their clients millions of dollars.

The increasing demand for cost-effective and efficient drug benefit programs is another key driver of the PBM market. With the rising costs of healthcare, employers and health plans are looking for ways to cut costs. PBMs are able to offer their clients significant savings on their drug benefit programs. In addition, PBMs can help their clients design drug benefit programs that are more efficient and cost-effective.

Restraints & Challenges

The key restraints and challenges in the pharmacy benefit management market include the following:

-The high cost of prescription drugs

-The need for more transparency in pricing and reimbursement

-The lack of standardization in the industry

-The need for more data to support decision making

-The challenges of managing a complex and ever-changing marketplace

Key Market Segments

The pharmacy benefit management market bifurcated on the basis of type, end-user, and region. On the basis of type, it is segmented into specialty pharmacy services, drug formulary management, mail order service, and others. By end-user, it is analyzed across pharmacy benefit management organization, mail order pharmacies, retail pharmacies, and others. Region-wise, it is studied across North America, Europe, Asia-Pacific, and rest of the World.

Key Market Players

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Chapter 1. Market Introduction
1.1. Objectives of the Study
1.2. Market Definition and Research & Scope
1.3. Research Methodologies
1.4. Market Estimation Techniques
Chapter 2. Executive Summary
2.1. Summary
2.2. Key Highlights of the Market
Chapter 3. Pharmacy Benefit Management Market Outlook
3.1. Pharmacy Benefit Management Market Segmentation
3.2. Market Dynamics
3.2.1. Market Drivers
3.2.1.1. Driver 1
3.2.1.2. Driver 2
3.2.1.3. Driver 3
3.2.2. Market Restraints
3.2.2.1. Restraint 1
3.2.2.2. Restraint 2
3.2.3. Market Opportunities
3.2.3.1. Opportunity 1
3.2.3.2. Opportunity 2
3.3. Porter’s Five Forces Analysis
3.3.1. Threat of New Entrants
3.3.2. Threat of Substitutes
3.3.3. Bargaining Power of Buyers
3.3.4. Bargaining Power of Supplier
3.3.5. Competitive Rivalry
3.4. PESTLE Analysis
3.5. Value Chain Analysis
3.5.1. Raw Material Suppliers
3.5.2. Manufacturers
3.5.3. Wholesalers and/or Retailers
3.6. Impact of the Russia and Ukraine War on the Global Pharmacy Benefit Management Market
Chapter 4. Economic Impact of COVID-19
4.1. Overall Impact of COVID-19
4.2. Impact of COVID On the Global Pharmacy Benefit Management Market
4.3. Economic Impact Analysis
Chapter 5. Pharmacy Benefit Management Market by Service
5.1. Market Overview
5.2. Specialty Pharmacy Services
5.2.1. Market Size and Forecast, 2021-2031 ($Million)
5.2.2. Market Size and Forecast, by Region, 2021-2031 ($Million)
5.3. Drug Formulary Management
5.3.1. Market Size and Forecast, 2021-2031 ($Million)
5.3.2. Market Size and Forecast, by Region, 2021-2031 ($Million)
5.4. Mail Order Services
5.4.1. Market Size and Forecast, 2021-2031 ($Million)
5.4.2. Market Size and Forecast, by Region, 2021-2031 ($Million)
5.5. Others
5.5.1. Market Size and Forecast, 2021-2031 ($Million)
5.5.2. Market Size and Forecast, by Region, 2021-2031 ($Million)
Chapter 6. Pharmacy Benefit Management Market by End User
6.1. Market Overview
6.2. Pharmacy Benefit Management Organization
6.2.1. Market Size and Forecast, 2021-2031 ($Million)
6.2.2. Market Size and Forecast, by Region, 2021-2031 ($Million)
6.3. Mail Order Pharmacies
6.3.1. Market Size and Forecast, 2021-2031 ($Million)
6.3.2. Market Size and Forecast, by Region, 2021-2031 ($Million)
6.4. Retail Pharmacies
6.4.1. Market Size and Forecast, 2021-2031 ($Million)
6.4.2. Market Size and Forecast, by Region, 2021-2031 ($Million)
6.5. Others
6.5.1. Market Size and Forecast, 2021-2031 ($Million)
6.5.2. Market Size and Forecast, by Region, 2021-2031 ($Million)
Chapter 7. Pharmacy Benefit Management Market, by Region
7.1. Overview
7.2. North America
7.2.1. Key Market Trends and Opportunities
7.2.2. North America Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.2.3. North America Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.2.4. North America Pharmacy Benefit Management Market Size and Forecast by Country, 2021-2031, ($Million)
7.2.5. The U.S.
7.2.5.1. The U.S. Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.2.5.2. The U.S. Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.2.6. Canada
7.2.6.1. Canada Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.2.6.2. Canada Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.2.7. Mexico
7.2.7.1. Mexico Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.2.7.2. Mexico Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.3. Europe
7.3.1. Key Market Trends and Opportunities
7.3.2. Europe Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.3.3. Europe Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.3.4. Europe Pharmacy Benefit Management Market Size and Forecast by Country, 2021-2031, ($Million)
7.3.5. Germany
7.3.5.1. Germany Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.3.5.2. Germany Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.3.6. France
7.3.6.1. France Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.3.6.2. France Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.3.7. U.K.
7.3.7.1. U.K. Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.3.7.2. U.K. Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.3.8. Spain
7.3.8.1. Spain Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.3.8.2. Spain Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.3.9. Italy
7.3.9.1. Italy Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.3.9.2. Italy Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.3.10. Rest of Europe
7.3.10.1. Rest of Europe Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.3.10.2. Rest of Europe Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.4. Asia-Pacific
7.4.1. Key Market Trends and Opportunities
7.4.2. Asia-Pacific Pharmacy Benefit Management Market Size and Forecast by Country, 2021-2031, ($Million)
7.4.3. Asia-Pacific Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.4.4. Asia-Pacific Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.4.5. China
7.4.5.1. China Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.4.5.2. China Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.4.6. India
7.4.6.1. India Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.4.6.2. India Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.4.7. Japan
7.4.7.1. Japan Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.4.7.2. Japan Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.4.8. South Korea
7.4.8.1. South Korea Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.4.8.2. South Korea Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.4.9. Rest of APAC
7.4.9.1. Rest of APAC Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.4.9.2. Rest of APAC Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.5. Rest of the World
7.5.1. Key Market Trends and Opportunities
7.5.2. Rest of the World Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.5.3. Rest of the World Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.5.4. Rest of the World Pharmacy Benefit Management Market Size and Forecast by Country, 2021-2031, ($Million)
7.5.5. Latin America
7.5.5.1. Latin America Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.5.5.2. Latin America Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.5.6. Middle East
7.5.6.1. Middle East Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.5.6.2. Middle East Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
7.5.7. Africa
7.5.7.1. Africa Pharmacy Benefit Management Market Size and Forecast by Service, 2021-2031, ($Million)
7.5.7.2. Africa Pharmacy Benefit Management Market Size and Forecast by End User, 2021-2031, ($Million)
Chapter 8. Competitive Landscape
8.1. Market Overview
8.2. Market Share Analysis/Key Player Positioning
8.3. Developmental Strategy Benchmarking
8.3.1. New Product Developments
8.3.2. Product Launches
8.3.3. Business Expansions
8.3.4. Partnerships, Joint Ventures, and Collaborations
8.3.5. Mergers and Acquisitions
Chapter 9. Company Profiles
9.1. Express Scripts Holding Company
9.1.1. Company Snapshot
9.1.2. Financial Performance
9.1.3. Product Offerings
9.1.4. Key Strategic Initiatives
9.1.5. SWOT Analysis
9.2. CVS Health Corporation
9.2.1. Company Snapshot
9.2.2. Financial Performance
9.2.3. Product offerings
9.2.4. Key Strategic Initiatives
9.2.5. SWOT Analysis
9.3. DST Systems, Inc.
9.3.1. Company Snapshot
9.3.2. Financial Performance
9.3.3. Product offerings
9.3.4. Key Strategic Initiatives
9.3.5. SWOT Analysis
9.4. Rite Aid Corp.
9.4.1. Company Snapshot
9.4.2. Financial Performance
9.4.3. Product offerings
9.4.4. Key Strategic Initiatives
9.4.5. SWOT Analysis
9.5. ProCare Rx.
9.5.1. Company Snapshot
9.5.2. Financial Performance
9.5.3. Product offerings
9.5.4. Key Strategic Initiatives
9.5.5. SWOT Analysis
9.6. United Health Group
9.6.1. Company Snapshot
9.6.2. Financial Performance
9.6.3. Product offerings
9.6.4. Key Strategic Initiatives
9.6.5. SWOT Analysis
9.7. Benecard Services, LLC
9.7.1. Company Snapshot
9.7.2. Financial Performance
9.7.3. Product offerings
9.7.4. Key Strategic Initiatives
9.7.5. SWOT Analysis
9.8. BioScrip, Inc
9.8.1. Company Snapshot
9.8.2. Financial Performance
9.8.3. Product offerings
9.8.4. Key Strategic Initiatives
9.8.5. SWOT Analysis
9.9. CaptureRx
9.9.1. Company Snapshot
9.9.2. Financial Performance
9.9.3. Product offerings
9.9.4. Key Strategic Initiatives
9.9.5. SWOT Analysis
9.10. Change Healthcare
9.10.1. Company Snapshot
9.10.2. Financial Performance
9.10.3. Product offerings
9.10.4. Key Strategic Initiatives
9.10.5. SWOT Analysis
*The list of company is subject to change during the final compilation of the report

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