Pharmacy Benefit Management Market Size (2024 - 2029)

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.