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Pharmacy Benefit Management Market Size (2024 - 2029)

The pharmacy benefit management market is projected to experience substantial growth, driven by an increasing adoption of pharmacy benefit management systems, rising health expenditures, and a growing demand for prescription products. The expansion of healthcare spending globally is expected to enhance the use of advanced software and solutions, facilitating better drug inventory and supply management, and making medications more accessible. This trend is anticipated to boost the market's scale during the forecast period. Additionally, the market's growth is supported by the demand for improved accuracy, safety, and efficiency in pharmacy operations, which enhances patient health outcomes. Despite these positive trends, challenges such as reluctance to adopt pharmacy automation systems and stringent regulatory processes regarding confidentiality may impede the market's expansion.

Market Size of Pharmacy Benefit Management Industry

Pharmacy Benefit Management Market Summary
Study Period 2019 - 2029
Market Size (2024) USD 589.40 Billion
Market Size (2029) USD 775.34 Billion
CAGR (2024 - 2029) 5.64 %
Fastest Growing Market Asia-Pacific
Largest Market North America
Market Concentration Low

Major Players

Pharmacy Benefit Management Market Major Players

*Disclaimer: Major Players sorted in no particular order

Pharmacy Benefit Management Market Analysis

The Pharmacy Benefit Management Market size is estimated at USD 589.40 billion in 2024, and is expected to reach USD 775.34 billion by 2029, growing at a CAGR of 5.64% during the forecast period (2024-2029).

  • The pharmacy benefit management market is experiencing significant growth due to a rising inclination toward pharmacy benefit management systems (PBMS), increasing health expenditure, and growing demand for prescription products. The rising health spending across the globe is expected to increase the adoption of technologically advanced software and solutions to monitor the inventory and supply of drugs and provide affordable medications to patients. This is anticipated to augment the market growth during the forecast period.
  • For instance, according to the Canadian Institute for Health Information published in November 2023, the healthcare expenditure in Canada reached USD 344 billion in 2023 from USD 334 billion in 2022. Thus, the significant increase in healthcare spending is expected to foster the adoption of advanced pharmacy benefit management systems to make medicines more accessible to patients.
  • The rising inclination toward pharmacy benefits management increases accuracy, improves the safety and efficiency of the pharmacy store, and improves patient health outcomes. This is anticipated to fuel the market's growth during the forecast period. For instance, in March 2022, Rite Aid's pharmacy benefit manager (PBM) division, Elixir, announced its Pharmaceutical Care Management Association (PCMA) membership. Elixir's inclusion in PCMA enhances patient access to cost-effective prescription medications. Thus, the growing demand for pharmacy benefit management services among drug manufacturers, retail pharmacies, and health insurance providers is expected to fuel the market growth during the forecast period.
  • Moreover, the company's rising activities in developing advanced software and solutions contribute to market growth. For instance, in July 2023, Prime Therapeutics LLC (Prime), a pharmacy benefit manager (PBM), unveiled its 2023 formulary recommendations for Humira. These recommendations aim to provide clients with cost-effective options, fostering heightened competition among manufacturers. Consequently, clients stand to benefit from potential savings on both Humira and its biosimilar alternatives.
  • Therefore, the market is expected to grow during the forecast period due to increasing healthcare expenditure and company activities. However, the reluctance to adopt pharmacy automation systems and stringent regulatory processes on confidentiality will likely hinder the growth of the pharmacy benefit management market during the forecast period.

Pharmacy Benefit Management Market Analysis

As per the scope of the report, the pharmacy benefit management market plays a significant role in the healthcare industry. It uniquely administers the pharmacy product and focuses on real-time interaction. Pharmacy benefit managers (PBMs) manage prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers, and other payers.

The pharmacy benefit management market is segmented by service, business model, end user, and geography. By service, the market is segmented into specialty pharmacy, drug formulary management, benefit plan design and consultation, and other services. By business model, the market is segmented into government health programs, employer-sponsored programs, and health insurance management. By end user, the market is segmented into pharmacy benefit management organizations, mail-order pharmacies, retail pharmacies, and other end users. By geography, the market is segmented into North America, Europe, Asia-Pacific, the Middle East and Africa, and South America. The report also covers the estimated market sizes and trends for 17 countries across major regions globally. The report offers the value (in USD) for the above segments.

By Service
Specialty Pharmacy
Drug Formulatory Management
Benefit Plan Design and Consultation
Other Services
By Business Model
Government Health Programs
Employer-Sponsored Programs
Health Insurance Management
By End User
Pharmacy Benefit Management Organization
Mail Order Pharmacies
Retail Pharmacies
Other End Users
Geography
North America
United States
Canada
Mexico
Europe
Germany
United Kingdom
France
Italy
Spain
Rest of Europe
Asia-Pacific
China
Japan
India
Australia
South Korea
Rest of Asia-Pacific
Middle East and Africa
GCC
South Africa
Rest of Middle East and Africa
South America
Brazil
Argentina
Rest of South America
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Pharmacy Benefit Management Market Size Summary

The pharmacy benefit management market is poised for substantial growth, driven by an increasing adoption of pharmacy benefit management systems, rising healthcare expenditures, and a growing demand for prescription products. The global surge in health spending is encouraging the implementation of advanced software solutions to manage drug inventory and supply, ensuring affordable medication access for patients. This trend is expected to significantly boost market expansion over the forecast period. The market's growth is further supported by the enhanced accuracy, safety, and efficiency of pharmacy operations, which contribute to improved patient health outcomes. The demand for pharmacy benefit management services is rising among drug manufacturers, retail pharmacies, and health insurance providers, further propelling market growth.

The specialty pharmacy segment is anticipated to experience notable growth due to the increasing demand for high-cost medications used to treat complex medical conditions and the rising burden of chronic diseases. Companies are actively developing specialty pharmacy software and solutions, which are expected to drive segment growth. North America is projected to witness significant market growth, fueled by the increasing number of medication errors, heightened adoption of pharmacy benefit management systems, and rising healthcare spending. The competitive landscape of the pharmacy benefit management market is characterized by the presence of several global players who are employing various growth strategies, such as partnerships, collaborations, and new product launches, to enhance their market presence.

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Pharmacy Benefit Management Market Size - Table of Contents

  1. 1. MARKET DYNAMICS

    1. 1.1 Market Overview

    2. 1.2 Market Drivers

      1. 1.2.1 Rising Inclination Towards Pharmacy Benefit Management System (PBMS)

      2. 1.2.2 Increasing Health Expenditure

      3. 1.2.3 Growing Demand for Prescription Products

    3. 1.3 Market Restraints

      1. 1.3.1 Reluctance To Adopt Pharmacy Automation Systems and Stringent Regulatory Procedures on Confidentiality

    4. 1.4 Porter's Five Forces Analysis

      1. 1.4.1 Threat of New Entrants

      2. 1.4.2 Bargaining Power of Buyers/Consumers

      3. 1.4.3 Bargaining Power of Suppliers

      4. 1.4.4 Threat of Substitute Products

      5. 1.4.5 Intensity of Competitive Rivalry

  2. 2. MARKET SEGMENTATION (Market Size by Value - USD)

    1. 2.1 By Service

      1. 2.1.1 Specialty Pharmacy

      2. 2.1.2 Drug Formulatory Management

      3. 2.1.3 Benefit Plan Design and Consultation

      4. 2.1.4 Other Services

    2. 2.2 By Business Model

      1. 2.2.1 Government Health Programs

      2. 2.2.2 Employer-Sponsored Programs

      3. 2.2.3 Health Insurance Management

    3. 2.3 By End User

      1. 2.3.1 Pharmacy Benefit Management Organization

      2. 2.3.2 Mail Order Pharmacies

      3. 2.3.3 Retail Pharmacies

      4. 2.3.4 Other End Users

    4. 2.4 Geography

      1. 2.4.1 North America

        1. 2.4.1.1 United States

        2. 2.4.1.2 Canada

        3. 2.4.1.3 Mexico

      2. 2.4.2 Europe

        1. 2.4.2.1 Germany

        2. 2.4.2.2 United Kingdom

        3. 2.4.2.3 France

        4. 2.4.2.4 Italy

        5. 2.4.2.5 Spain

        6. 2.4.2.6 Rest of Europe

      3. 2.4.3 Asia-Pacific

        1. 2.4.3.1 China

        2. 2.4.3.2 Japan

        3. 2.4.3.3 India

        4. 2.4.3.4 Australia

        5. 2.4.3.5 South Korea

        6. 2.4.3.6 Rest of Asia-Pacific

      4. 2.4.4 Middle East and Africa

        1. 2.4.4.1 GCC

        2. 2.4.4.2 South Africa

        3. 2.4.4.3 Rest of Middle East and Africa

      5. 2.4.5 South America

        1. 2.4.5.1 Brazil

        2. 2.4.5.2 Argentina

        3. 2.4.5.3 Rest of South America

Pharmacy Benefit Management Market Size FAQs

The Pharmacy Benefit Management Market size is expected to reach USD 589.40 billion in 2024 and grow at a CAGR of 5.64% to reach USD 775.34 billion by 2029.

In 2024, the Pharmacy Benefit Management Market size is expected to reach USD 589.40 billion.

Pharmacy Benefit Management Market Size & Share Analysis - Growth Trends & Forecasts (2024 - 2029)