The Market Reports

Synopsis
The global market for Pharmacy Benefit Management (PBM) was estimated to be worth US$ 515320 million in 2024 and is forecast to a readjusted size of US$ 755530 million by 2031 with a CAGR of 5.7% during the forecast period 2025-2031.
The term pharmacy benefit management (PBM) industry refers to a group of companies that serve as the middlemen between insurance companies, pharmacies, and drug manufacturers. PBMs are responsible for securing lower drug costs for insurers and insurance companies. They accomplish this by negotiating with pharmacies and drug manufacturers. The discounts are then passed onto insurance companies. Profits are generated through the slight up-charging of drugs or retaining portions of rebates.
Market Driver:
The Pharmacy Benefit Management (PBM) market is driven by the rising demand for cost-effective prescription drug management amid increasing healthcare expenditures. As drug prices continue to rise, PBMs play a crucial role in negotiating discounts, managing formularies, and implementing cost-containment strategies to make medications more affordable for insurers, employers, and patients. The growing prevalence of chronic diseases such as diabetes and cardiovascular disorders has also increased prescription drug usage, further boosting the need for PBM services. Additionally, advancements in digital health technologies, including electronic prior authorization and AI-driven drug utilization review, are enhancing PBM efficiency and expanding market opportunities.
Market Challenge:
Despite its benefits, the PBM market faces challenges related to pricing transparency and regulatory scrutiny. Many stakeholders, including policymakers and consumers, criticize PBMs for a lack of transparency in drug pricing and rebate structures, leading to concerns about whether cost savings are fully passed on to patients. Regulatory pressures are also increasing, with governments implementing reforms to ensure fair pricing practices and limit excessive profit margins. Additionally, growing competition from integrated healthcare models—where insurers and pharmacies establish their own PBM services—poses a threat to traditional PBM companies, potentially reshaping market dynamics.
Top major PBMs maufacturters include Express Scripts, CVS Health, and OptumRx, which comprise 75% of the market. America is enjoying the largest market share of pharmacy benefit management (PBM), with a market share nearly 97%. EU is the second place, enjoying market share nearly 2%.In terms of product, government is the largest segment, with a share over 70%. And in terms of application, the largest application is non-mail pharmacy services, followed by mail-order pharmacy services.
This report aims to provide a comprehensive presentation of the global market for Pharmacy Benefit Management (PBM), focusing on the total sales revenue, key companies market share and ranking, together with an analysis of Pharmacy Benefit Management (PBM) by region & country, by Type, and by Application.
The Pharmacy Benefit Management (PBM) market size, estimations, and forecasts are provided in terms of sales revenue ($ millions), considering 2024 as the base year, with history and forecast data for the period from 2020 to 2031. With both quantitative and qualitative analysis, to help readers develop business/growth strategies, assess the market competitive situation, analyze their position in the current marketplace, and make informed business decisions regarding Pharmacy Benefit Management (PBM).
Market Segmentation
By Company
CVS Health (CVS)
Express Scripts
OptumRx (UnitedHealth)
Humana Pharmacy Solutions
Prime Therapeutics
Medimpact Healthcare
Magellan Health
BC/BS
Vidalink
Sea Rainbow
Cachet
CRHMS
Segment by Type
Government
Non-Government
Segment by Application
Mail-order Pharmacy Services
Non-mail Pharmacy Services
By Region
North America
United States
Canada
Asia-Pacific
China
Japan
South Korea
Southeast Asia
India
Australia
Rest of Asia-Pacific
Europe
Germany
France
U.K.
Italy
Netherlands
Nordic Countries
Rest of Europe
Latin America
Mexico
Brazil
Rest of Latin America
Middle East & Africa
Turkey
Saudi Arabia
UAE
Rest of MEA
Chapter Outline
Chapter 1: Introduces the report scope of the report, global total market size. This chapter also provides the market dynamics, latest developments of the market, the driving factors and restrictive factors of the market, the challenges and risks faced by manufacturers in the industry, and the analysis of relevant policies in the industry.
Chapter 2: Detailed analysis of Pharmacy Benefit Management (PBM) company competitive landscape, revenue market share, latest development plan, merger, and acquisition information, etc.
Chapter 3: Provides the analysis of various market segments by Type, covering the market size and development potential of each market segment, to help readers find the blue ocean market in different market segments.
Chapter 4: Provides the analysis of various market segments by Application, covering the market size and development potential of each market segment, to help readers find the blue ocean market in different downstream markets.
Chapter 5: Revenue of Pharmacy Benefit Management (PBM) in regional level. It provides a quantitative analysis of the market size and development potential of each region and introduces the market development, future development prospects, market space, and market size of each country in the world.
Chapter 6: Revenue of Pharmacy Benefit Management (PBM) in country level. It provides sigmate data by Type, and by Application for each country/region.
Chapter 7: Provides profiles of key players, introducing the basic situation of the main companies in the market in detail, including product revenue, gross margin, product introduction, recent development, etc.
Chapter 8: Analysis of industrial chain, including the upstream and downstream of the industry.
Chapter 9: Conclusion.

Index