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Report
Pharmacy Benefit Management Market in the US - Industry Outlook & Forecast 2022-2027
Market Report I 2022-05-17 I 212 Pages I Arizton Advisory & Intelligence
The study considers a detailed scenario of the present U.S. pharmacy benefit management market and its market dynamics for 2022?2027. It covers a detailed overview of several industry growth enablers, restraints, and trends. The report offers both the demand and supply aspects of the market. It profiles and examines leading companies and other prominent ones operating in the market.
The U.S. pharmacy benefit management market is expected to grow at a CAGR of 5.53% during 2022-2027
MARKET INSIGHTS
The PBM industry refers to companies that act as intermediaries between insurance companies, pharmacies, and pharmaceutical companies. PBM is responsible for reducing insurers and their drug costs. They achieve this by negotiating with pharmacies and pharmaceutical companies. The pharmacy benefit management systems entered the pharmaceutical industry in the 1960s to meet the needs of employer-based health benefits. They soon became an important stakeholder in the entire pharmaceutical supply chain.
Pharmacy costs represent almost 32% of the total health care spending, and this expenditure is expected to grow more than two times during the forecast period. Currently, pharmacy benefit management plays a major role and acts as an intermediary between payers, drug manufacturers, and pharmacies.
Since PBMs play a significant role in influencing out-of-pocket costs and patient access to medications owing to their management tools, formulary power, and price concessions. They are in a position of power to pass savings to customers. According to PBM lobby groups, between 2020 to 2029, PBM tools will reduce consumer and plan sponsors' spending by more than $1 trillion.
There is a growing criticism of PBMs with claims that they are driving up costs of drug prices, making huge gains via pharmacy spreads, rebates from manufacturers, and fees from the supply chain. This is being spurred by the opaqueness of the true cost of drugs to PBMs owing to the rules of engagement between manufacturers and PBMs.
The future of PBMs is going to be dictated by the implementation of state and national-level policies in terms of their revenue streams and business practices in the pharmaceutical space.
U.S. Pharmacy Benefit Management Market Segmentations
Based on services, specialty pharmacy services are the major contributor in the pharmacy benefit management market in the US, and it is likely to witness high incremental growth of $48.24 billion during the forecast period.
Based on health plans, commercial health plans are the major contributor in the pharmacy benefit management market in the US, and it is likely to witness high absolute growth of 34.69% during the forecast period.
Segmentation by Health Plan
Commercial Health Plans
Medicare
Medicaid
Others
Segmentation by Services
Specialty Pharmacy Services
Retail Pharmacy Networks
Mail-Order Pharmacy Services
Claims Processing
Formulary Management
Drug Utilization Review
Price, Discount, & Rebate Negotiations
Disease Management & Adherence Initiatives
Segmentation by Business Model
Insurance Companies and Retail Pharmacies
Pure Play PBMS
VENDOR ANALYSIS
The presence of prominent market players, increasing favorable healthcare reforms, rising e-prescription, and growing adoption of healthcare plans by us residents are the primary factors for the significant market share in the country.
Key Company Profiles
CVS Health
Cigna
UnitedHealth Group
Key Companies to Watch
Humana Pharmacy Solutions
Medimpact
Prime Therapeutics
Other Prominent Vendors
Abarca Health
AscellaHealth
BeneCard PBF
CaptureRx
Centene
Change Healthcare
Citizens Rx
EnvisionRxOptions
Excelera
Magellan Rx Management
MedalistRx
MaxorPlus
Navitus Health Solutions
PerformRx
ProCare Rx
RxAdvance
Rite Aid
WellDyneRx
Walgreens Boots Alliance
1 RESEARCH METHODOLOGY
2 RESEARCH OBJECTIVES
3 RESEARCH PROCESS
4 SCOPE & COVERAGE
4.1 MARKET DEFINITION
4.1.1 INCLUSIONS
4.1.2 EXCLUSIONS
4.1.3 MARKET ESTIMATION CAVEATS
4.2 BASE YEAR
4.3 SCOPE OF THE STUDY
4.4 MARKET SEGMENTATION
4.4.1 MARKET SEGMENTATION BY SERVICE
4.4.2 MARKET SEGMENTATION BY HEALTH PLAN
4.4.3 MARKET SEGMENTATION BY BUSINESS MODEL
5 REPORT ASSUMPTIONS & CAVEATS
5.1 KEY CAVEATS
5.2 CURRENCY CONVERSION
5.3 MARKET DERIVATION
6 MARKET AT A GLANCE
7 INTRODUCTION
7.1 US ECONOMY & HEALTHCARE INDUSTRY LANDSCAPE
7.2 PHARMACY BENEFIT MANAGEMENT
7.2.1 ROLE OF PBMS IN MONEY SPENT ON PRESCRIPTION DRUGS
7.2.2 REFORMS TO REGULATE PBMS
8 PHARMACEUTICAL ECOSYSTEM
8.1 OVERVIEW
8.2 EVOLUTION OF PBM OWNERSHIP
8.2.1 PBM SERVICES OVER TIME
8.2.2 PBMS & OTHER PLAYERS IN PHARMACEUTICAL ECOSYSTEM
9 IMPACT OF COVID-19 ON PBM MARKET
9.1 OVERVIEW
9.1.1 PBMS COVID-19 RESPONSE STRATEGIES
10 GAPS IN INFORMATION & CARE IN US HEALTHCARE INDUSTRY
10.1 OVERVIEW
11 MARKET OPPORTUNITIES & TRENDS
11.1 INCREASED ADOPTION OF E-PRESCRIPTION & MAIL ORDER PHARMACY
11.2 GROWING FDA APPROVALS OF BIOLOGICS & BIOSIMILARS
11.3 MARKET ENTRY OF PAYERS THROUGH M&AS
11.4 ENTRY OF DIGITAL HEALTH SOLUTIONS IN PBM INDUSTRY
12 MARKET GROWTH ENABLERS
12.1 FAVORABLE HEALTHCARE REFORMS
12.2 GROWING ADOPTION OF HEALTHCARE PLANS BY US RESIDENTS
12.3 PREVALENCE OF FRAUD, WASTE & ABUSE IN HEALTHCARE
12.4 INCREASED DEMAND FOR PERSONALIZED MEDICINES
13 MARKET RESTRAINTS
13.1 PBMS MORE SUSCEPTIBLE TO LAWSUITS & GOVERNMENT SCRUTINY
13.2 LACK OF TRANSPARENCY IN SERVICES BY PBMS
13.3 DECLINING GROWTH FROM GENERICS
13.4 LEGAL UNCERTAINTY & IMPENDING LIMITATIONS ON PBM TOOLS
14 MARKET LANDSCAPE
14.1 MARKET OVERVIEW
14.2 MARKET SIZE & FORECAST
14.2.1 INSIGHT BY HEALTH PLANS
14.2.2 INSIGHTS BY SERVICES
14.2.3 INSIGHT BY BUSINESS MODEL
14.3 FIVE FORCES ANALYSIS
14.3.1 THREAT OF NEW ENTRANTS
14.3.2 BARGAINING POWER OF SUPPLIERS
14.3.3 BARGAINING POWER OF BUYERS
14.3.4 THREAT OF SUBSTITUTES
14.3.5 COMPETITIVE RIVALRY
15 HEALTH PLANS
15.1 MARKET SNAPSHOT & GROWTH ENGINE
15.2 MARKET OVERVIEW
15.3 COMMERCIAL HEALTH PLANS
15.3.1 MARKET OVERVIEW
15.3.2 MARKET SIZE & FORECAST
15.4 MEDICARE
15.4.1 MARKET OVERVIEW
15.4.2 MARKET SIZE & FORECAST
15.5 MEDICAID
15.5.1 MARKET OVERVIEW
15.5.2 MARKET SIZE & FORECAST
15.6 OTHERS
15.6.1 MARKET OVERVIEW
15.6.2 MARKET SIZE & FORECAST
16 SERVICES
16.1 MARKET SNAPSHOT & GROWTH ENGINE
16.2 MARKET OVERVIEW
16.3 SPECIALTY PHARMACY SERVICES
16.3.1 MARKET OVERVIEW
16.3.2 MARKET SIZE & FORECAST
16.4 RETAIL PHARMACY NETWORKS
16.4.1 MARKET OVERVIEW
16.4.2 MARKET SIZE & FORECAST
16.5 MAIL-ORDER PHARMACY SERVICES
16.5.1 MARKET OVERVIEW
16.5.2 MARKET SIZE & FORECAST
16.6 CLAIMS PROCESSING
16.6.1 MARKET OVERVIEW
16.6.2 MARKET SIZE & FORECAST
16.7 FORMULARY MANAGEMENT
16.7.1 MARKET OVERVIEW
16.7.2 MARKET SIZE & FORECAST
16.8 DRUG UTILIZATION REVIEW
16.8.1 MARKET OVERVIEW
16.8.2 MARKET SIZE & FORECAST
16.9 PRICE, DISCOUNT & REBATE NEGOTIATIONS
16.9.1 MARKET OVERVIEW
16.9.2 MARKET SIZE & FORECAST
16.10 DISEASE MANAGEMENT & ADHERENCE INITIATIVES
16.10.1 MARKET OVERVIEW
16.10.2 MARKET SIZE & FORECAST
17 BUSINESS MODEL
17.1 MARKET SNAPSHOT & GROWTH ENGINE
17.2 MARKET OVERVIEW
17.3 INSURANCE COMPANIES & RETAIL PHARMACIES
17.3.1 MARKET OVERVIEW
17.3.2 MARKET SIZE & FORECAST
17.4 PURE PLAY PBMS
17.4.1 MARKET OVERVIEW
17.4.2 MARKET SIZE & FORECAST
18 COMPETITIVE LANDSCAPE
18.1 COMPETITION OVERVIEW
18.2 MARKET SHARE ANALYSIS
18.2.1 CVS HEALTH
18.2.2 CIGNA
18.2.3 UNITEDHEALTH GROUP
18.2.4 HUMANA PHARMACY SOLUTIONS
18.2.5 MEDIMPACT
18.2.6 PRIME THERAPEUTICS
19 KEY COMPANY PROFILES
19.1 CVS HEALTH
19.1.1 BUSINESS OVERVIEW
19.1.2 SERVICE OFFERINGS
19.1.3 KEY STRENGTHS
19.1.4 KEY STRATEGIES
19.1.5 KEY OPPORTUNITY
19.2 CIGNA
19.2.1 BUSINESS OVERVIEW
19.2.2 SERVICE OFFERINGS
19.2.3 KEY STRENGTHS
19.2.4 KEY STRATEGIES
19.2.5 KEY OPPORTUNITY
19.3 UNITEDHEALTH GROUP
19.3.1 BUSINESS OVERVIEW
19.3.2 SERVICE OFFERINGS
19.3.3 KEY STRENGTH
19.3.4 KEY STRATEGIES
19.3.5 KEY OPPORTUNITY
20 KEY COMPANIES TO WATCH
20.1 HUMANA PHARMACY SOLUTIONS
20.1.1 BUSINESS OVERVIEW
20.1.2 SERVICE OFFERINGS
20.1.3 KEY STRENGTHS
20.1.4 KEY STRATEGIES
20.1.5 KEY OPPORTUNITY
20.2 MEDIMPACT
20.2.1 BUSINESS OVERVIEW
20.2.2 SERVICE OFFERINGS
20.2.3 KEY STRENGTHS
20.2.4 KEY STRATEGIES
20.2.5 KEY OPPORTUNITIES
20.3 PRIME THERAPEUTICS
20.3.1 BUSINESS OVERVIEW
20.3.2 SERVICE OFFERINGS
20.3.3 KEY STRENGTHS
20.3.4 KEY STRATEGIES
21 OTHER PROMINENT VENDORS
21.1 ABARCA HEALTH
21.1.1 BUSINESS OVERVIEW
21.1.2 SERVICE OFFERINGS
21.1.3 KEY STRENGTHS
21.1.4 KEY STRATEGIES
21.2 ANTHEM
21.2.1 BUSINESS OVERVIEW
21.2.2 SERVICE OFFERINGS
21.2.3 KEY STRATEGIES
21.2.4 KEY STRENGTHS
21.3 ASCELLAHEALTH
21.3.1 BUSINESS OVERVIEW
21.3.2 SERVICE OFFERINGS
21.3.3 KEY STRENGTHS
21.3.4 KEY STRATEGIES
21.4 BENECARD PBF
21.4.1 BUSINESS OVERVIEW
21.4.2 SERVICE OFFERINGS
21.4.3 KEY STRENGTHS
21.4.4 KEY STRATEGIES
21.5 CAPTURERX
21.5.1 BUSINESS OVERVIEW
21.5.2 SERVICE OFFERINGS
21.5.3 KEY STRENGTHS
21.5.4 KEY STRATEGIES
21.6 CENTENE
21.6.1 BUSINESS OVERVIEW
21.6.2 SERVICE OFFERINGS
21.6.3 KEY STRENGTHS
21.6.4 KEY STRATEGIES
21.7 CHANGE HEALTHCARE
21.7.1 BUSINESS OVERVIEW
21.7.2 SERVICE OFFERINGS
21.7.3 KEY STRENGTHS
21.7.4 KEY STRATEGIES
21.8 CITIZENS RX
21.8.1 BUSINESS OVERVIEW
21.8.2 SERVICE OFFERINGS
21.8.3 KEY STRENGTHS
21.8.4 KEY STRATEGIES
21.9 ENVISIONRXOPTIONS
21.9.1 BUSINESS OVERVIEW
21.9.2 SERVICE OFFERINGS
21.9.3 KEY STRENGTHS
21.9.4 KEY STRATEGIES
21.10 EXCELERA
21.10.1 BUSINESS OVERVIEW
21.10.2 SERVICE OFFERINGS
21.10.3 KEY STRENGTHS
21.10.4 KEY STRATEGIES
21.11 MAGELLAN RX MANAGEMENT
21.11.1 BUSINESS OVERVIEW
21.11.2 SERVICE OFFERINGS
21.11.3 KEY STRENGTHS
21.11.4 KEY STRATEGIES
21.12 MEDALISTRX
21.12.1 BUSINESS OVERVIEW
21.12.2 SERVICE OFFERINGS
21.12.3 KEY STRENGTH
21.12.4 KEY STRATEGIES
21.13 MAXORPLUS
21.13.1 BUSINESS OVERVIEW
21.13.2 SERVICE OFFERINGS
21.13.3 KEY STRENGTHS
21.13.4 KEY STRATEGIES
21.14 NAVITUS HEALTH SOLUTIONS
21.14.1 BUSINESS OVERVIEW
21.14.2 SERVICE OFFERINGS
21.14.3 KEY STRENGTH
21.14.4 KEY STRATEGY
21.15 PERFORMRX
21.15.1 BUSINESS OVERVIEW
21.15.2 SERVICE OFFERINGS
21.15.3 KEY STRENGTHS
21.15.4 KEY STRATEGIES
21.16 PROCARE RX
21.16.1 BUSINESS OVERVIEW
21.16.2 SERVICE OFFERINGS
21.16.3 KEY STRENGTHS
21.16.4 KEY STRATEGIES
21.17 RXADVANCE
21.17.1 BUSINESS OVERVIEW
21.17.2 SERVICE OFFERINGS
21.17.3 KEY STRENGTHS
21.17.4 KEY STRATEGIES
21.18 RITE AID
21.18.1 BUSINESS OVERVIEW
21.18.2 SERVICE OFFERINGS
21.18.3 KEY STRENGTHS
21.18.4 KEY STRATEGIES
21.19 WELLDYNERX
21.19.1 BUSINESS OVERVIEW
21.19.2 SERVICE OFFERINGS
21.19.3 KEY STRENGTHS
21.19.4 KEY STRATEGIES
21.20 WALGREENS BOOTS ALLIANCE
21.20.1 BUSINESS OVERVIEW
21.20.2 SERVICE OFFERINGS
21.20.3 KEY STRENGTHS
21.20.4 KEY STRATEGIES
22 REPORT SUMMARY
22.1 KEY TAKEAWAYS
22.2 STRATEGIC RECOMMENDATIONS
23 QUANTITATIVE SUMMARY
23.1 MARKET BY HEALTH PLANS
23.2 MARKET BY SERVICES
23.3 MARKET BY BUSINESS MODEL
24 APPENDIX
24.1 ABBREVIATIONS
LIST OF EXHIBITS
EXHIBIT 1 SEGMENTATION OF PHARMACY BENEFIT MANAGEMENT (PBM) MARKET IN US
EXHIBIT 2 MARKET SIZE CALCULATION APPROACH 2021
EXHIBIT 3 ROLE OF PBMS IN PROVIDING SERVICES & FLOW OF FUNDS FOR PRESCRIPTION DRUGS
EXHIBIT 4 PRESCRIPTION DRUG EXPENDITURES 2011?2027 ($ BILLION)
EXHIBIT 5 NUMBER OF DRUG APPROVALS IN PIPELINE FOR 2020
EXHIBIT 6 PBMS RESPONSE TOWARDS COVID-19
EXHIBIT 7 US MEDICATION NON-ADHERENCE STATISTICS 2019
EXHIBIT 8 IMPACT OF INCREASED ADOPTION OF E-PRESCRIPTION & MAIL ORDER PHARMACY
EXHIBIT 9 HER ADOPTION RATE IN US
EXHIBIT 10 IMPACT OF GROWING FDA APPROVALS OF BIOLOGICS & BIOSIMILARS
EXHIBIT 11 NUMBER OF BIOLOGICS APPROVED BY US FDA IN 2000?2010 & 2011?2020
EXHIBIT 12 PERCENTAGE SHARE OF BIOLOGICS APPROVED BY US FDA 2016?2021
EXHIBIT 13 IMPACT OF MARKET ENTRY OF PAYERS THROUGH M&AS
EXHIBIT 14 IMPACT OF ENTRY OF DIGITAL HEALTH SOLUTIONS IN PBM INDUSTRY
EXHIBIT 15 IMPACT OF FAVORABLE HEALTHCARE REFORMS
EXHIBIT 16 AVERAGE MONTHLY PREMIUMS FOR 16 NATIONAL PART D STANDALONE DRUG PLANS
EXHIBIT 17 IMPACT OF GROWING ADOPTION OF HEALTHCARE PLANS BY US RESIDENTS
EXHIBIT 18 STANDALONE DRUG PLANS & MEDICARE ADVANTAGE DRUG PLANS
EXHIBIT 19 MEDICAID SPENDING BY US RESIDENTS
EXHIBIT 20 IMPACT OF PREVALENCE OF FRAUD, WASTE & ABUSE IN HEALTHCARE
EXHIBIT 21 OVERVIEW OF FRAUD, WASTE & ABUSE IN US 2019
EXHIBIT 22 IMPACT OF INCREASED DEMAND FOR PERSONALIZED MEDICINES
EXHIBIT 23 IMPACT OF PBMS MORE SUSCEPTIBLE TO LAWSUITS & GOVERNMENT SCRUTINY
EXHIBIT 24 IMPACT OF LACK OF TRANSPARENCY IN SERVICES BY PBMS
EXHIBIT 25 IMPACT OF DECLINING GROWTH FROM GENERICS
EXHIBIT 26 SHARE OF GENERIC VERSUS BRANDED DRUG PRESCRIPTIONS DISPENSED IN US 2008?2018
EXHIBIT 27 IMPACT OF LEGAL UNCERTAINTY & IMPENDING LIMITATIONS ON PBM TOOLS
EXHIBIT 28 THE CASE FOR PBMS
EXHIBIT 29 PHARMACY BENEFIT MANAGEMENT MARKET IN US 20212027 ($ BILLION)
EXHIBIT 30 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY HEALTH PLANS: MARKET SHARE 2021 & 2027
EXHIBIT 31 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY SERVICES: MARKET SHARE 2021 & 2027
EXHIBIT 32 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY BUSINESS MODEL: MARKET SHARE 2021 & 2027
EXHIBIT 33 FIVE FORCES ANALYSIS 2021
EXHIBIT 34 INCREMENTAL GROWTH BY HEALTH PLANS 2021 & 2027
EXHIBIT 35 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY HEALTH PLANS: INCREMENTAL GROWTH
EXHIBIT 36 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY HEALTH PLANS: ABSOLUTE GROWTH
EXHIBIT 37 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY COMMERCIAL HEALTH PLANS: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 38 US PHARMACY BENEFIT MANAGEMENT MARKET BY COMMERCIAL HEALTH PLANS 20212027 ($ BILLION)
EXHIBIT 39 US PHARMACY BENEFIT MANAGEMENT MARKET IN US BY MEDICARE: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 40 US PHARMACY BENEFIT MANAGEMENT MARKET BY MEDICARE 20212027 ($ BILLION)
EXHIBIT 41 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY MEDICAID: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 42 US PHARMACY BENEFIT MANAGEMENT MARKET BY MEDICAID 20212027 ($ BILLION)
EXHIBIT 43 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY OTHERS: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 44 US PHARMACY BENEFIT MANAGEMENT MARKET BY OTHERS 20212027 ($ BILLION)
EXHIBIT 45 INCREMENTAL GROWTH BY SERVICES 2021 & 2027
EXHIBIT 46 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY SERVICES: INCREMENTAL GROWTH
EXHIBIT 47 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY SERVICES: ABSOLUTE GROWTH
EXHIBIT 48 STATISTICS ON SPECIALTY DRUGS IN US 2019
EXHIBIT 49 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY SPECIALTY PHARMACY SERVICES: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 50 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY SPECIALTY PHARMACY SERVICES 20212027 ($ BILLION)
EXHIBIT 51 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY RETAIL PHARMACY NETWORKS: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 52 PBMS WITH NETWORK PHARMACY
EXHIBIT 53 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY RETAIL PHARMACY NETWORKS 20212027 ($ BILLION)
EXHIBIT 54 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY MAIL-ORDER PHARMACY SERVICES: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 55 MAIL-ORDER PHARMACY SERVICES SAVE MONEY
EXHIBIT 56 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY MAIL-ORDER PHARMACY SERVICES 20212027 ($ BILLION)
EXHIBIT 57 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY CLAIMS PROCESSING: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 58 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY CLAIMS PROCESSING20212027 ($ BILLION)
EXHIBIT 59 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY FORMULARY MANAGEMENT: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 60 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY FORMULARY MANAGEMENT 20212027 ($ BILLION)
EXHIBIT 61 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY DRUG UTILIZATION REVIEW: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 62 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY DRUG UTILIZATION REVIEW 20212027 ($ BILLION)
EXHIBIT 63 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY PRICE, DISCOUNT & REBATE NEGOTIATIONS: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 64 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY PRICE, DISCOUNT & REBATE NEGOTIATIONS 20212027 ($ BILLION)
EXHIBIT 65 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY DISEASE MANAGEMENT & ADHERENCE INITIATIVES: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 66 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY DISEASE MANAGEMENT & ADHERENCE INITIATIVES 20212027 ($ BILLION)
EXHIBIT 67 INCREMENTAL GROWTH BY BUSINESS MODEL 2021 & 2027
EXHIBIT 68 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY BUSINESS MODEL: INCREMENTAL GROWTH
EXHIBIT 69 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY INSURANCE COMPANIES & RETAIL PHARMACIES: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 70 US PHARMACY BENEFIT MANAGEMENT MARKET BY INSURANCE COMPANIES & RETAIL PHARMACIES 20212027 ($ BILLION)
EXHIBIT 71 US PHARMACY BENEFIT MANAGEMENT MARKET IN US BY PURE PLAY PBMS: INCREMENTAL & ABSOLUTE GROWTH
EXHIBIT 72 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY PURE PLAY PBMS 20212027 ($ BILLION)
EXHIBIT 73 COMPETITIVE ANALYSIS OF KEY VENDORS: PHARMACY BENEFIT MANAGEMENT MARKET IN US
EXHIBIT 74 PHARMACY BENEFIT MANAGEMENT MARKET IN US: KEY VENDORS RANKING 2021
EXHIBIT 75 KEY VENDOR CAPABILITIES COMPARISON IN US PHARMACY BENEFIT MANAGEMENT MARKET
EXHIBIT 76 CVS HEALTH: TOTAL REVENUE 20192021 ($ MILLION)
EXHIBIT 77 CVS HEALTH REVENUE SHARE BY BUSINESS SEGMENTS 20192021 (%)
EXHIBIT 78 CIGNA: TOTAL REVENUE 20192021 ($ MILLION)
EXHIBIT 79 CIGNA: REVENUE BY BUSINESS SEGMENT 2021 (%)
EXHIBIT 80 UNITEDHEALTH GROUP: TOTAL REVENUE 20192021 ($ MILLION)
EXHIBIT 81 UNITEDHEALTH GROUP: REVENUE BY BUSINESS PLATFORM 2020 (%)
LIST OF TABLES
TABLE 1 KEY CAVEATS
TABLE 2 CURRENCY CONVERSION 2015?2021
TABLE 3 PBMS PARTICIPATION WITH OTHER PLAYER PHARMACEUTICAL ECOSYSTEM
TABLE 4 CVS HEALTH: MAJOR SERVICE OFFERINGS
TABLE 5 CIGNA: MAJOR SERVICE OFFERINGS
TABLE 6 UNITEDHEALTH GROUP: MAJOR SERVICE OFFERINGS
TABLE 7 HUMANA PHARMACY SOLUTIONS: MAJOR SERVICE OFFERINGS
TABLE 8 MEDIMPACT: MAJOR SERVICE OFFERINGS
TABLE 9 PRIME THERAPEUTICS: MAJOR SERVICE OFFERINGS
TABLE 10 ABARCA HEALTH: MAJOR SERVICE OFFERINGS
TABLE 11 ANTHEM: MAJOR SERVICE OFFERINGS
TABLE 12 ASCELLAHEALTH: MAJOR SERVICE OFFERINGS
TABLE 13 BENECARD PBF: MAJOR SERVICE OFFERINGS
TABLE 14 CAPTURERX: MAJOR SERVICE OFFERINGS
TABLE 15 CENTENE: MAJOR SERVICE OFFERINGS
TABLE 16 CHANGE HEALTHCARE: MAJOR SERVICE OFFERINGS
TABLE 17 CITIZENS RX: MAJOR SERVICE OFFERINGS
TABLE 18 ENVISIONRXOPTIONS: MAJOR SERVICE OFFERINGS
TABLE 19 EXCELERA: MAJOR SERVICE OFFERINGS
TABLE 20 MAGELLAN RX MANAGEMENT: MAJOR SERVICE OFFERINGS
TABLE 21 MEDALISTRX: MAJOR SERVICE OFFERINGS
TABLE 22 MAXORPLUS: MAJOR SERVICE OFFERINGS
TABLE 23 NAVITUS HEALTH SOLUTIONS: MAJOR SERVICE OFFERINGS
TABLE 24 PERFORMRX: MAJOR SERVICE OFFERINGS
TABLE 25 PROCARE RX: MAJOR SERVICE OFFERINGS
TABLE 26 RXADVANCE: MAJOR SERVICE OFFERINGS
TABLE 27 RITE AID: MAJOR SERVICE OFFERINGS
TABLE 28 WELLDYNERX: MAJOR SERVICE OFFERINGS
TABLE 29 WALGREENS BOOTS ALLIANCE: MAJOR SERVICE OFFERINGS
TABLE 30 PHARMACY BENEFIT MANAGEMENT MARKET THE US BY HEALTH PLANS 2021?2027 ($ BILLION)
TABLE 31 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY HEALTH PLANS 2021?2027 (%)
TABLE 32 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY SERVICES 2021?2027 ($ BILLION)
TABLE 33 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY SERVICES 2021?2027 (%)
TABLE 34 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY BUSINESS MODEL 2021?2027 ($ BILLION)
TABLE 35 PHARMACY BENEFIT MANAGEMENT MARKET IN US BY BUSINESS MODEL 2021?2027 (%)
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As we work in close partnership with our Partners from time to time we can secure discounts and assist with negotiations, this is part of our personalised service to you.
Discounts can sometimes be arranged for speedily placed orders; multiple report purchases or Higher License purchases.
To check if a Discount is possible please Contact our experienced team through ‘? ASK A QUESTION’, support@scotts-international.com, or by telephoning 0048 603 394 346.
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- Available Currencies
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Most Market Reports on our platform are listed in USD or EURO based on the wishes of our Partners. To avoid currency fluctuations and potential price differentiations we do not offer the possibility to change the currency online.
Should you wish to pay in a different currency to that advertised online we do accept payments in USD, EURO, GBP and PLN. The price will be calculated based on the relevant exchange rate taken from our National Bank.
To pay in a different above currency to that advertised online please Contact our team and a quotation will be sent within a couple of hours with payment details.
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- Licenses
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License options vary from Partner to Partner as is usually based on the number of Users that will benefitting from the report. It is very important that License ordered is not breached as this could have potential negative consequences for you individually or your employer.
If you have questions or need confirmation about the specific license we recommend you to Contact us and a detailed explanation will be provided.
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- Global Site License
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The Global Site License is the most comprehensive license available. By selecting this license, the Market Report can be shared with other ‘Allowed Users’ and any other member of staff from the same organisation regardless of geographic location.
It is important to note that this may exclude Parent Companies or Subsidiaries.
If you have questions or need confirmation about the specific license we recommend you to Contact us and a detailed explanation will be provided.
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- Formats
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The most common format is PDF, however in certain circumstances data may be present in Excel format or Online, especially in the case of Database or Directories. In addition, for certain higher license options a CD may also be provided.
If you have questions or need clarification about the specific formats we recommend you to Contact us and a detailed explanation will be provided.
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- Delivery
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Delivery is fulfilled by our partners directly. Once an order has been placed we inform the partner by sharing the delivery email details given in the order process.
Delivery is usually made within 24 hours of an order being placed, however it may take longer should your order be placed prior to the weekend or if otherwise specified on the Market Report details page. Additionally, if details have been not fully completed in the Order process a delay in delivery is possible.
If a delay in delivery is expected you will be informed about it immediately.
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- Shipping Charges
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As most Market Reports are delivered in PDF format we almost never have to add additional Shipping Charges. If, however you are ordering a Higher License service or a specific delivery format (e.g. CD version) charges may apply.
If you are concerned about additional Shipping Charges we recommend you to Contact us to double check.
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- Prices
- Ordering
- By Credit Card
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We work in Partnership with PayU to ensure payments are made securely in a fast and effortless way. PayU is the e-payments division of Naspers.
Naspers operates in over 133 International Markets and ranks 3rd Globally in terms of the number of e-commerce customers served.
For more information on PayU please visit: https://www.payu.pl/en/about-us
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- By Money Transfer
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If you require an invoice prior to payment, this is possible. To ensure a speedy delivery of the Market Report we require all relevant company details and you agree to maximum payment terms of 30 days from receipt of order.
With our regular clients deliver of the Market Report can be made prior to receiving payment, however in some circumstances we may ask for payment to be received before arranging for the Market Report to be delivered.
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- By Credit Card
- Security
- Website security
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We have specifically partnered with leading International companies to protect your privacy by using different technologies and processes to ensure security.
Everything submitted to Scotts International is encrypted via SSL (Secure Socket Layer) and all personal information provided to Scotts International is stored on computer systems with limited access in controlled environments.
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- Credit Card Security
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We partner with PayU (https://www.payu.pl/en/about-us) to ensure all credit card payments are made securely in a fast and effortless way.
PayU offers 250+ various payment channels and eWallet services across 4 continents allowing buyers to pay electronically, whether on a computer or a mobile device.
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- Website security