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Pharmacy Benefit Management (PBM) Market Size, Share & Industry Analysis, By Service (Specialty Pharmacy Services, Benefit Plan Design & Administration, Pharmacy Claims Processing, Formulary Management, Others), By Service Providers (Insurance Companies, Retail Pharmacies, Standalone PBMs) and Regional Forecast 2021-2028

Region : Global | Report ID: FBI103496 | Status : Ongoing



Pharmacy benefit managers (PBMs) refer to companies that manage prescription drug benefits on behalf of large scale employers, health insurance agencies, Medicare Part D drug plans, and other payers. They are particularly critical as they enable the negotiations with various pharmaceutical companies and pharmacies to control the cost of medications. At the same instance, they ensure the access of important and critical medications to patients through such actions. In the current scenario, the market has been subjected to the strong growth of the prescription drug expenditure as the demand for critical medications such as life saving drugs have increased sharply. Hence, for the timely and appropriate access to medications, the presence of a pharmacy benefit management (PBM) is extremely useful and needed in the current scenario.

The pharmacy benefit management (PBM) market is expected to register a strong growth rate during the forecast period due to factors such as increasing prescription drug expenditure, increasing prevalence of chronic diseases, increases in technological advancements in pharmacy benefit management (PBM), and growing adoption of healthcare IT. However, the lack of adequate adoption in the developing regions due to absence of healthcare IT infrastructure are some of the major factors likely to restrict the growth of global market.

Key Market Driver -

Increase in Demand for Prescription Drugs

Key Market Restraint -

Lack of Adoption in Developing Regions

Market Segmentation:

Globally, the pharmacy benefit management (PBM) market can be segmented on the basis of service, service providers, and region. Based on service, the market can be segmented into specialty pharmacy services, benefit plan design & administration, pharmacy claims processing, formulary management and others. Based on service providers, the market can be segmented into insurance companies, retail pharmacies, and standalone PBMs. Geographically, the pharmacy benefit management (PBM) market is segmented into North America, Europe, Asia Pacific, Latin America, Middle East and Africa.

Key Players Covered:

Some of the major companies that are present in the pharmacy benefit management (PBM) market are CVS Health, Express Scripts, OptumRx, Inc., Anthem, Inc., Centene Corporation, CIGNA, MedImpact, and other prominent players.

Key Insights:

  • Impact of COVID-19 Outbreak on Global Pharmaceutical Market

  • Strategies Adopted by Leading Market Players

  • Snapshot of the Regulatory Scenario of the Global Pharmacy Benefit Management (PBM) Market

  • Impact of COVID-19 on Pharmacy Benefit Management (PBM) Market

  • Overview of the Steps Taken by Pharmacy Benefit Management (PBM) Vendors during COVID-19

  • Key Industry Developments (Mergers, Acquisitions, And Collaborations)

Regional Analysis:

Geographically, the pharmacy benefit management (PBM) market is segmented into North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa. North America is projected to account as the dominant market share. The dominance of North America can be primarily attributed to the factors such as strong prescription drug expenditure, high prevalence of chronic diseases amongst the general population, and presence of technological advancements in pharmacy benefit management (PBM) programs. For instance, according to the Centers for Disease Control and Prevention (CDC), in 2018, 26.9 million people of all ages—or 8.2% of the American population, had received a diagnosis of diabetes. Europe is expected to account for the second largest market share in global market. Strong potential patient population, presence and adoption of technologically advanced healthcare IT, and strong healthcare expenditure are primarily responsible for the market expansion in Europe. On the other hand, the market in Asia Pacific is expected to grow with the highest CAGR primarily due to increasing prescription drug expenditure and increasing adoption of advanced healthcare infrastructure. Latin America and the Middle East & Africa are anticipated to account for comparatively lower market revenue shares and growth rates. However, strong improvement in healthcare infrastructure coupled with increasing demand for prescription drugs in these regions are likely to aid the market growth in the upcoming years.

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By Service

  • Specialty Pharmacy Services

  • Benefit Plan Design & Administration

  • Pharmacy Claims Processing

  • Formulary Management

  • Others

By Service Providers

  • Insurance Companies

  • Retail Pharmacies

  • Standalone PBMs

By Geography

  • North America (USA, Canada)

  • Europe (UK, Germany, France, Italy, Spain, Scandinavia, and Rest of Europe)

  • Asia Pacific (Japan, China, India, Australia, Southeast Asia, and Rest of Asia Pacific)

  • Latin America (Brazil, Mexico, Rest of Latin America)

  • Middle East & Africa (South Africa, GCC, and Rest of the Middle East & Africa)

Pharmacy Benefit Management (PBM) Market Industry Developments

  • In January 2020, RxSense, the healthcare technology company, announced the launch of their industry-leading analytics product, RxIQ, further enhancing the transformative enterprise solution for pharmacy benefits administration, RxAgile

  • In January 2019, Anthem announced the launch of its pharmacy benefit management (PBM) company IngenioRx earlier, thus ending the Express Scripts deal in March


Pharmacy Benefit Management (PBM) Market Size, Share and Global Industry Trend Forecast till 2026
  • Ongoing
  • 2020
  • 2017-2019


  • $4850

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