세계의 PBM(Pharmacy Benefit Management) 시장 보고서(2025년)
Pharmacy Benefit Management Global Market Report 2025
상품코드 : 1824545
리서치사 : The Business Research Company
발행일 : On Demand Report
페이지 정보 : 영문 250 Pages
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한글목차

PBM(Pharmacy Benefit Management) 시장 규모는 향후 수년간 강력한 성장이 예상됩니다. 2029년 연평균 성장률(CAGR)은 8.4%를 나타내 9,589억 4,000만 달러로 성장할 전망입니다. 예측 기간의 성장은 건강 관리 비용 억제 요구, 처방약 사용량 증가, 의료 보험 확대, 규제 변경 준수, 환자 중심 건강 관리로 인한 것으로 간주됩니다. 예측 기간의 주요 동향에는 가치 기반 건강 관리 모델, 전문 약물 관리, 데이터 분석 및 AI 통합, 원격 의료 통합, 맞춤형 의료 증가 등이 있습니다.

향후 5년간의 성장률 8.4%라고 하는 예측은 전회 예측으로부터 0.2%의 소폭의 감소를 반영하고 있습니다. 이 감소는 주로 미국과 다른 국가 간의 관세의 영향 때문입니다. 무역 마찰은 인도와 아일랜드에서 개발된 인공지능 주도의 처방 관리 플랫폼과 청구 처리 소프트웨어의 가격을 상승시켜 처방 승인 지연과 관리 비용 상승을 초래함으로써 미국의 의료비 부담의 경감을 방해할 수 있습니다. 또한 상호관세와 무역의 긴장과 한계 증가로 인한 세계경제와 무역에 대한 악영향으로 인해 그 영향이 더욱 광범위해질 것으로 보입니다.

보험에 가입하는 개인 수 증가는 PBM(Pharmacy Benefit Management) 시장 성장의 중요한 촉진요인입니다. 보험은 치료, 입원, 건강 진단 및 기타 관련 의료 지출과 관련된 비용을 포함하여 의료비 증가에 대처하는 데 도움이 됩니다. 마찬가지로 PBM은 의료 서비스와 의약품 서비스를 모두 통합하여 종합적인 건강 관리 제품에 대한 지원을 제공합니다. 이 접근법을 통해 보험 회사는 환자 데이터에 대한 자세한 인사이트를 얻을 수 있으며 환자에게 효과적인 프로그램을 제공할 수 있습니다. 예를 들어, 미국 연방 정부의 각료급 부국인 미국 보건 복지부는 2024년 보험 가입 기간(OEP) 동안 2023년 OEP에 비해 510만 명의 추가 가입자가 있었고 보험 가입이 31% 증가했다고 보고했습니다. 그 결과 보험 가입 증가가 PBM(Pharmacy Benefit Management) 시장 성장에 박차를 가하고 있습니다.

목차

제1장 주요 요약

제2장 시장 특징

제3장 시장 동향과 전략

제4장 시장 - 거시경제 시나리오 금리, 인플레이션, 지정학, 무역전쟁과 관세, 그리고 코로나 및 회복이 시장에 미치는 영향을 포함한 거시경제 시나리오

제5장 세계의 성장 분석과 전략 분석 프레임워크

제6장 시장 세분화

제7장 지역별/국가별 분석

제8장 아시아태평양 시장

제9장 중국 시장

제10장 인도 시장

제11장 일본 시장

제12장 호주 시장

제13장 인도네시아 시장

제14장 한국 시장

제15장 서유럽 시장

제16장 영국 시장

제17장 독일 시장

제18장 프랑스 시장

제19장 이탈리아 시장

제20장 스페인 시장

제21장 동유럽 시장

제22장 러시아 시장

제23장 북미 시장

제24장 미국 시장

제25장 캐나다 시장

제26장 남미 시장

제27장 브라질 시장

제28장 중동 시장

제29장 아프리카 시장

제30장 경쟁 구도와 기업 프로파일

제31장 기타 주요 기업 및 혁신 기업

제32장 세계 시장 경쟁 벤치마킹과 대시보드

제33장 주요 인수합병(M&A)

제34장 최근 시장 동향

제35장 시장의 잠재력이 높은 국가, 부문, 전략

제36장 부록

KTH
영문 목차

영문목차

Pharmacy benefit management refers to a network of businesses acting as intermediaries between insurance companies, pharmacies, and drug distributors. Its primary purpose is to facilitate the negotiation process between insurers and pharmaceutical companies, aiming to secure reduced prescription costs.

The primary services offered by pharmacy benefit management (PBM) include mail-delivery, specialty pharmacy, and preferred network pharmacy. Mail-delivery involves the direct shipment of medicines to the desired location through mail-order delivery services. These services are extended across various types of PBMs, which include commercial health plans, self-insured employer plans, Medicare Part D plans, and the Federal Employees Health Benefits Program. Different types of PBMs serve major end-users, including pharmacy benefit management organizations, mail-order pharmacies, retail pharmacies, inpatient pharmacies, and outpatient pharmacies, catering to diverse needs within the healthcare sector.

Note that the outlook for this market is being affected by rapid changes in trade relations and tariffs globally. The report will be updated prior to delivery to reflect the latest status, including revised forecasts and quantified impact analysis. The report's Recommendations and Conclusions sections will be updated to give strategies for entities dealing with the fast-moving international environment.

The sharp rise in U.S. tariffs and the resulting trade tensions in spring 2025 are having a significant impact on the healthcare sector, especially in the supply of essential medical devices, diagnostic equipment, and pharmaceuticals. Hospitals and healthcare providers are grappling with higher costs for imported surgical tools, imaging systems, and consumables like syringes and catheters, many of which have limited domestic substitutes. These escalating expenses are putting pressure on healthcare budgets, prompting some providers to delay equipment upgrades or pass increased costs on to patients. Furthermore, tariffs on raw materials and components are disrupting the manufacturing of vital drugs and devices, leading to supply chain delays. In response, the industry is adopting diversified sourcing strategies, expanding local production where feasible, and pushing for tariff exemptions on critical medical products.

The pharmacy benefit management market research report is one of a series of new reports from The Business Research Company that provides pharmacy benefit management market statistics, including pharmacy benefit management industry global market size, regional shares, competitors with a pharmacy benefit management market share, detailed pharmacy benefit management market segments, market trends and opportunities, and any further data you may need to thrive in the pharmacy benefit management industry. This pharmacy benefit management market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenarios of the industry.

The pharmacy benefit management market size has grown strongly in recent years. It will grow from $648.75 billion in 2024 to $695.73 billion in 2025 at a compound annual growth rate (CAGR) of 7.2%. The growth in the historic period can be attributed to increased focus on preventative care, pharmacy network expansion, partnerships with healthcare providers, focus on patient outcomes, advancements in pharmaceutical therapies.

The pharmacy benefit management market size is expected to see strong growth in the next few years. It will grow to $958.94 billion in 2029 at a compound annual growth rate (CAGR) of 8.4%. The growth in the forecast period can be attributed to healthcare cost control demands, rise in prescription drug usage, health insurance expansion, adherence to regulatory changes, patient-centric healthcare. Major trends in the forecast period include value-based healthcare models, specialty medications management, data analytics and AI integration, telemedicine integration, rise in personalized medicine.

The forecast of 8.4% growth over the next five years reflects a slight reduction of 0.2% from the previous projection. This reduction is primarily due to the impact of tariffs between the US and other countries. Trade tensions could hinder U.S. healthcare affordability by inflating prices of Artificial intelligence-driven formulary management platforms and claims processing software developed in India and Ireland, resulting in delayed prescription approvals and higher administrative costs. The effect will also be felt more widely due to reciprocal tariffs and the negative effect on the global economy and trade due to increased trade tensions and restrictions.

The increase in the number of individuals obtaining insurance is a significant driver for the growth of the pharmacy benefit management (PBM) market. Insurance helps address rising medical expenses by covering costs associated with treatments, hospital stays, health check-ups, and other related medical expenditures. Likewise, PBM provides comprehensive healthcare product support by integrating both medical and pharmaceutical services. This approach offers insurers detailed insights into patient data, enabling them to deliver effective programs to patients. For example, the United States Department of Health and Human Services, a cabinet-level department of the U.S. federal government, reported a 31% increase in coverage sign-ups, with 5.1 million additional consumers enrolling during the 2024 Open Enrollment Period (OEP) compared to the 2023 OEP. Consequently, the rise in insurance uptake is fueling the growth of the pharmacy benefit management market.

The escalating prevalence of chronic diseases is anticipated to drive the growth of the pharmacy benefit management (PBM) market in the coming years. Chronic diseases, characterized by long-term health conditions persisting for three months or more, pose a significant global health challenge. Pharmacy benefit management is instrumental in the effective management of chronic diseases by optimizing medication access, fostering adherence, and implementing cost-effective strategies. This approach ensures improved health outcomes and a higher quality of life for individuals dealing with long-term medical conditions. As of September 2023, the World Health Organization (WHO) reported that noncommunicable diseases (NCDs) or chronic diseases accounted for 74% of the 41 million annual global deaths. Notably, this figure includes 17.9 million deaths attributed to cardiovascular diseases, 9.3 million to cancer, 4.1 million to chronic respiratory diseases, and 2.0 million to diabetes. Consequently, the rising prevalence of chronic diseases stands as a significant factor propelling the growth of the pharmacy benefit management market.

Leading companies in the pharmacy benefit management (PBM) market are prioritizing acquisitions and partnerships to increase market share. Such deals enable companies to broaden their product portfolios and drive higher sales. For example, in December 2022, Prime Therapeutics LLC, a U.S.-based pharmacy solutions company specializing in PBM, acquired Magellan Rx Management for $1.35 billion, integrating its PBM services with specialty drug management expertise. This acquisition aims to expand service offerings, boost affordability, improve patient care, increase membership, and maintain operational independence. The acquisition aligns with the healthcare sector's 'Quadruple Aim' goals, strengthening Prime Therapeutics' PBM platform. Magellan Rx Management, also U.S.-based, specializes in comprehensive pharmacy and medical benefits management.

Prominent companies in the PBM market are also introducing digital prescription technologies to enhance prescription drug cost management. Digital prescription technology involves electronic systems to create, transmit, store, and manage medication prescriptions. For instance, in August 2024, UNC Health, a U.S.-based medical system, launched UNC Health Pharmacy Solutions, an advanced PBM platform blending clinical excellence with a transparent model for prescription cost management. The platform offers up to 32% in total savings along with comprehensive pharmacy services and has achieved a Net Promoter Score of 95. UNC Health aims to be the preferred PBM in North and South Carolina, helping partners reduce overall care costs and improve member outcomes. The program utilizes dynamic plan management, unique strategies for biosimilars and weight-loss medications, and individualized consultations with clinical pharmacists.

In January 2022, Centene, a prominent US-based managed care company specializing in healthcare solutions for individuals and families, successfully completed the acquisition of Magellan, a leading US-based entity renowned for its expertise in managing the most rapidly expanding and intricate segments of the healthcare industry. This strategic transaction, valued at $2.2 billion, positions Centene to deliver comprehensive, integrated healthcare solutions tailored for complex, high-cost populations. The acquisition aims to enhance health outcomes while concurrently achieving cost efficiencies within this specialized sector.

Major companies operating in the pharmacy benefit management market include CVS Health Corporation, Cigna Corporation, Centene Corporation, Anthem Inc., OptumRx Inc., Humana Pharmacy Solutions Inc., Magellan Health Inc., Prime Therapeutics LLC, MaxorPlus Ltd., RxAdvance Corp, MedImpact Healthcare Systems Inc., PerformRx LLC., Navitus Health Solutions LLC, WellDyneRx Inc., Healthesystems LLC., Catalyst Rx Inc., Argus Health Systems Inc., Innoviant Pharmacy Inc., Pharmaceutical Strategies Group, ProCare Rx Inc., FutureScripts LLC., National CooperativeRx, ScriptCare Ltd., US Script Inc., LDI Integrated Pharmacy Services LLC, RxPreferred Benefits, SinfoniaRx Inc.

North America was the largest region in the pharmacy benefit management market in 2024. Asia-Pacific is expected to be the fastest-growing region in the forecast period. The regions covered in the pharmacy benefit management market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa.

The countries covered in the pharmacy benefit management market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA, Canada, Italy, Spain.

The pharmacy benefit management market includes revenues earned by entities by providing case management, disease management, and drug utilization services. The market value includes the value of related goods sold by the service provider or included within the service offering. Only goods and services traded between entities or sold to end consumers are included.

The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD, unless otherwise specified).

The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.

Pharmacy Benefit Management Global Market Report 2025 from The Business Research Company provides strategists, marketers and senior management with the critical information they need to assess the market.

This report focuses on pharmacy benefit management market which is experiencing strong growth. The report gives a guide to the trends which will be shaping the market over the next ten years and beyond.

Reasons to Purchase

Where is the largest and fastest growing market for pharmacy benefit management ? How does the market relate to the overall economy, demography and other similar markets? What forces will shape the market going forward, including technological disruption, regulatory shifts, and changing consumer preferences? The pharmacy benefit management market global report from the Business Research Company answers all these questions and many more.

The report covers market characteristics, size and growth, segmentation, regional and country breakdowns, competitive landscape, market shares, trends and strategies for this market. It traces the market's historic and forecast market growth by geography.

The forecasts are made after considering the major factors currently impacting the market. These include the technological advancements such as AI and automation, Russia-Ukraine war, trade tariffs (government-imposed import/export duties), elevated inflation and interest rates.

Scope

Table of Contents

1. Executive Summary

2. Pharmacy Benefit Management Market Characteristics

3. Pharmacy Benefit Management Market Trends And Strategies

4. Pharmacy Benefit Management Market - Macro Economic Scenario Macro Economic Scenario Including The Impact Of Interest Rates, Inflation, Geopolitics, Trade Wars and Tariffs, And Covid And Recovery On The Market

5. Global Pharmacy Benefit Management Growth Analysis And Strategic Analysis Framework

6. Pharmacy Benefit Management Market Segmentation

7. Pharmacy Benefit Management Market Regional And Country Analysis

8. Asia-Pacific Pharmacy Benefit Management Market

9. China Pharmacy Benefit Management Market

10. India Pharmacy Benefit Management Market

11. Japan Pharmacy Benefit Management Market

12. Australia Pharmacy Benefit Management Market

13. Indonesia Pharmacy Benefit Management Market

14. South Korea Pharmacy Benefit Management Market

15. Western Europe Pharmacy Benefit Management Market

16. UK Pharmacy Benefit Management Market

17. Germany Pharmacy Benefit Management Market

18. France Pharmacy Benefit Management Market

19. Italy Pharmacy Benefit Management Market

20. Spain Pharmacy Benefit Management Market

21. Eastern Europe Pharmacy Benefit Management Market

22. Russia Pharmacy Benefit Management Market

23. North America Pharmacy Benefit Management Market

24. USA Pharmacy Benefit Management Market

25. Canada Pharmacy Benefit Management Market

26. South America Pharmacy Benefit Management Market

27. Brazil Pharmacy Benefit Management Market

28. Middle East Pharmacy Benefit Management Market

29. Africa Pharmacy Benefit Management Market

30. Pharmacy Benefit Management Market Competitive Landscape And Company Profiles

31. Pharmacy Benefit Management Market Other Major And Innovative Companies

32. Global Pharmacy Benefit Management Market Competitive Benchmarking And Dashboard

33. Key Mergers And Acquisitions In The Pharmacy Benefit Management Market

34. Recent Developments In The Pharmacy Benefit Management Market

35. Pharmacy Benefit Management Market High Potential Countries, Segments and Strategies

36. Appendix

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