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U.S. prescription market: market share of pharmacy benefit managers 2018
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U.S. prescription market: market share of pharmacy benefit managers 2018
Market share of the top 5 pharmacy benefit managers in the U.S. prescription market in 2018
by Matej Mikulic,
last edited
Aug 9, 2019
In 2018, the top pharmacy benefit managers included CVS Health, Express Scripts, and OptumRx, to name a few. CVS Health had the largest share of the pharmacy benefit manager market in 2018. In total CVS Health held 30 percent of the market at that time. Pharmacy benefit managers are an important part of the prescription drug supply chain.
Pharmacy benefit managers
Pharmacy benefit managers are responsible for the operation and distribution of pharmaceuticals to patients and pharmacies. They are also responsible for the negotiation of rebates and processing of insurance claims from patients and pharmacies. Among pharmaceutical distributors in the U.S., chain stores distributed the larges value of pharmaceuticals in recent years. However, data suggests that pharmacy benefit managers have the highest gross profit among all actors in the U.S. drugs supply chain.
Generic drugs
In recent years, the growth of the generic prescriptions volume in the U.S. market has remained fairly stable with growth in all years. With stable growth in generics, the number of brand name medicines that were excluded from pharmacy benefit manager formularies in recent years had been on the rise. Generic drugs are useful to the consumer in that, in many cases, they provide a cheaper (but equal) alternative to brand name drugs.
Market share of the top 5 pharmacy benefit managers in the U.S. prescription market in 2018
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by Matej Mikulic,
last edited
Aug 9, 2019
In 2018, the top pharmacy benefit managers included CVS Health, Express Scripts, and OptumRx, to name a few. CVS Health had the largest share of the pharmacy benefit manager market in 2018. In total CVS Health held 30 percent of the market at that time. Pharmacy benefit managers are an important part of the prescription drug supply chain.
Pharmacy benefit managers
Pharmacy benefit managers are responsible for the operation and distribution of pharmaceuticals to patients and pharmacies. They are also responsible for the negotiation of rebates and processing of insurance claims from patients and pharmacies. Among pharmaceutical distributors in the U.S., chain stores distributed the larges value of pharmaceuticals in recent years. However, data suggests that pharmacy benefit managers have the highest gross profit among all actors in the U.S. drugs supply chain.
Generic drugs
In recent years, the growth of the generic prescriptions volume in the U.S. market has remained fairly stable with growth in all years. With stable growth in generics, the number of brand name medicines that were excluded from pharmacy benefit manager formularies in recent years had been on the rise. Generic drugs are useful to the consumer in that, in many cases, they provide a cheaper (but equal) alternative to brand name drugs.
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- Release date
- March 2019
- Region
- United States
- Survey time period
- 2018
- Supplementary notes
-
Market share based on total prescription claims.
* Includes pro forma combination of claims processed by Aetna. Excludes double counting of network claims for mail choice claims filled at CVS retain pharmacies.
** Includes Anthem. During 2019, Anthem claims will be transitioning to IngenioRx.
***Includes Cigna. By the end of 2020, Cigna claims will transition to Express Scripts.
**** Figure includes some cash pay prescriptions that use a discount card processed by one of the 6 PBMs shown on the chart.
Source
- Show sources information
- As a Premium user you get access to the detailed source references and background information about this statistic.
- Show publisher information
- Release date
- March 2019
More information
- Region
- United States
- Survey time period
- 2018
- Supplementary notes
-
Market share based on total prescription claims.
* Includes pro forma combination of claims processed by Aetna. Excludes double counting of network claims for mail choice claims filled at CVS retain pharmacies.
** Includes Anthem. During 2019, Anthem claims will be transitioning to IngenioRx.
***Includes Cigna. By the end of 2020, Cigna claims will transition to Express Scripts.
**** Figure includes some cash pay prescriptions that use a discount card processed by one of the 6 PBMs shown on the chart.
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- U.S. prescription medicines in 2012: volume by pharmacy benefit manager
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