薬剤給付管理（PBM）の米国市場 - 市場規模、シェア、動向分析：ビジネスモデル別、最終用途別、セグメント予測（2023年～2030年）

米国の薬剤給付管理（PBM）の市場規模は、2030年までに9,340億米ドルに達し、2023年～2030年にCAGRで8.77%の成長が予測されています。

主に医療費の増加、薬剤給付管理（PBM）に対する選好の高まり、処方薬に対する需要の増加が、市場成長を促進しています。

当レポートでは、米国の薬剤給付管理（PBM）市場について調査分析し、市場の動向、セグメント分析、地域分析、競合情勢などを提供しています。

目次

第1章 調査範囲と目的

第2章 調査手法

第3章 エグゼクティブサマリー

• 市場の見通し
• セグメントの見通し
  • ビジネスモデル
  • 最終用途
    • 競合の考察

第4章 市場の変数、動向、範囲

• 市場系列の見通し
  • 親企業の市場の見通し
  • 付随/関連する市場の見通し
• 市場力学
  • 市場促進要因の分析
  • 市場抑制要因の分析
• 浸透と成長の見通しのマッピング
• 事業環境分析ツール
  • ポーターのファイブフォース分析
  • PESTEL分析
• COVID-19の影響：質的分析

第5章 米国の薬剤給付管理（PBM）市場：ビジネスモデル分析

• 米国の薬剤給付管理（PBM）のビジネスモデルの市場シェア分析（2022年・2030年）
• 米国の薬剤給付管理（PBM）のビジネスモデル市場：セグメントダッシュボード
• ビジネスモデルセグメントの市場規模と予測、動向の分析（2017年～2030年）
  • スタンドアロンPBM
  • 健康保険企業
  • 小売薬局

第6章 米国の薬剤給付管理（PBM）市場：最終用途分析

• 米国の薬剤給付管理（PBM）の最終用途の市場シェア分析（2022年・2030年）
• 米国の薬剤給付管理（PBM）の最終用途市場：セグメントダッシュボード
• 最終用途セグメントの市場規模と予測、動向の分析（2017年～2030年）
  • 商業
  • 連邦政府

第7章 競合分析

• 最近の動向と影響の分析：主な市場参入企業別
• 競合の分類（主なイノベーター、マーケットリーダー、新興企業）
• 企業の市場ポジションの分析
• 企業プロファイル
  • CVS HEALTH
  • Elixir Rx Solutions LLC
  • Optum, Inc
  • Cigna
  • Change Healthcare
  • MedImpact
  • Prime Therapeutics LLC
  • HUB International Limited.
  • Anthem

List of Tables

• TABLE 1 List of secondary sources
• TABLE 2 List of abbreviations
• TABLE 3 U.S. U.S. pharmacy benefit management market, by business model, 2017 - 2030 (USD Billion)
• TABLE 4 U.S. U.S. pharmacy benefit management market, by end-use, 2017 - 2030 (USD Billion)

List of Figures

• FIG. 1 Market research process
• FIG. 2 Information procurement
• FIG. 3 Primary research pattern
• FIG. 4 Market research approaches
• FIG. 5 Value chain based sizing & forecasting
• FIG. 6 QFD modeling for market share assessment
• FIG. 7 Market formulation & validation
• FIG. 8 Market outlook
• FIG. 9 Pharmacy benefit management market segmentation
• FIG. 10 Market trends & outlook
• FIG. 11 Market driver relevance analysis (Current & future impact)
• FIG. 12 Market restraint relevance analysis (Current & future impact)
• FIG. 13 Penetration & growth prospect mapping
• FIG. 14 U.S. pharmacy benefit management business model market share analysis, 2022 & 2030
• FIG. 15 U.S. pharmacy benefit management business model market: Segment dashboard
• FIG. 16 Standalone PBM market, 2017 - 2030 (USD Billion)
• FIG. 17 Health insurance providers market, 2017 - 2030 (USD Billion)
• FIG. 18 Retail pharmacy market, 2017- 2030 (USD Billion)
• FIG. 19 U.S. pharmacy benefit management market end-use movement analysis, 2022 & 2030
• FIG. 20 U.S. pharmacy benefit management end-use market: Segment dashboard
• FIG. 21 Commercial market, 2017 - 2030 (USD Billion)
• FIG. 22 Federal market, 2017- 2030 (USD Billion)
• FIG. 23 Recent developments & impact analysis, by key market participants
• FIG. 24 Strategy framework
• FIG. 25 Competition Categorization
• FIG. 26 Company market position analysis

U.S. Pharmacy Benefit Management Market Growth & Trends:

The U.S. pharmacy benefit management market size is expected to reach USD 934.0 billion by 2030, exhibiting a CAGR of 8.77% from 2023 to 2030, according to a new report by Grand View Research, Inc. Increase in healthcare cost, the growing preference for pharmacy benefit management (PBM), and increased demand for prescription drugs are primarily driving the market growth.

PBMs operate with specialty pharmacies to enable beneficiaries to better adherence. These systems provide wide expertise and connections with pharmaceutical companies that can be beneficial to establish drug contracts. Payers find it difficult to establish value-based contracts with pharmaceutical companies. Therefore, payers promote themselves as negotiators and tend to receive considerable discounts on prescription drugs

The vertical integration of pharmacy benefit management (PBM) organizations with health insurance companies is poised to result in increased control of PBMs over distribution systems. This is likely to cause a rise in rebates, ultimately increasing the cost of drug list prices. Moreover, it will result in a monopoly of a certain market player, concentrating sales and revenue generation.

The business of insuring and administering employee benefit programs in the country, especially, health care programs, is heavily regulated by federal and state laws and administrative agencies, such as the Department of Health and Human Services (HHS), State Departments of Insurance, Centers for Medicare & Medicaid Services (CMS), Internal Revenue Services, and Departments of Labor.

The U.S. market for PBM is further fueled by the increasing number of mergers and collaborations between pharmacy benefit management businesses and health insurance providers for bettering the affordability and customization of health insurance policies. Additionally, the launch of enhanced benefit management services, such as disease management, drug utilization programmes, and pharmacy-medical integrated goods, is expected to bode well for the market.

U.S. Pharmacy Benefit Management Market Report Highlights:

• The standalone segment accounted for the largest revenue share in 2022 owing to the high number of claims processing by PBM. The health insurance segment is expected to witness a significant growth rate during the forecast period

• Based on end-use, the commercial segment accounted for the largest market share in 2022. The growth of the segment is attributed due to the proliferated usage of private insurance by the public and the increased cost of drugs

• In February 2022, Southern Scripts, one of the top PBM launched RxCompass, a new solution for mitigating the high cost of prescription drugs for companies and employees in the U.S.

• In July 2021, major insurers Humana and Anthem announced a partnership with SS&C, a software solutions provider to create a new PBM company named DomaniRx

Table of Contents

Chapter 1 Report Scope and Objectives

• 1.1 Market Segmentation
• 1.2 Regional Scope
• 1.3 Estimates and Forecast Timeline
• 1.4 Research Objectives
  • 1.4.1 Objective - 1
  • 1.4.2 Objective - 2
  • 1.4.3 Objective - 3

Chapter 2 Methodology

• 2.1 Research Methodology
• 2.2 Information Procurement
  • 2.2.1 Purchased Database
  • 2.2.2 GVR's Internal Database
  • 2.2.3 Secondary Sources
  • 2.2.4 Primary Research
  • 2.2.5 Details of Primary Research
• 2.3 Information or Data Analysis
  • 2.3.1 Data Analysis Models
• 2.4 Market Formulation & Validation
• 2.5 Model Details
  • 2.5.1 Commodity Flow Analysis
• 2.6 List of Secondary Sources
• 2.7 List of Abbreviations

Chapter 3 Executive Summary

• 3.1 Market Outlook
• 3.2 Segment Outlook
  • 3.2.1 Business Model
  • 3.2.2 End - use
    • 3.3Competitive Insights

Chapter 4 Market Variables, Trends & Scope

• 4.1 Market Lineage outlook
  • 4.1.1 Parent market outlook
  • 4.1.2 Ancillary/related market outlook
• 4.2 Market Dynamics
  • 4.2.1 Market driver analysis
    • 4.2.1.1 Vertical integration of key market players
    • 4.2.1.2 Introduction of improved health benefit plans
    • 4.2.1.3 Growing prevalence of chronic diseases in the U.S.
  • 4.2.2 Market restraint analysis
    • 4.2.2.1 Stringent regulations to cut back rebates
• 4.3 Penetration & Growth Prospect Mapping
• 4.4 Business Environment Analysis Tools
  • 4.4.1 Porter's Five Forces analysis
    • 4.4.1.1 Competitive rivalry
    • 4.4.1.2 Threat of new entrants
    • 4.4.1.3 Bargaining power of buyers
    • 4.4.1.4 Bargaining power of suppliers
    • 4.4.1.5 Threat of substitutes
  • 4.4.2 PESTEL Analysis
    • 4.4.2.1 Political landscape
    • 4.4.2.2 Economic and social landscape
    • 4.4.2.3 Technological landscape
• 4.3 Impact of COVID - 19: Qualitative Analysis

Chapter 5 U.S. Pharmacy Benefit Management Market: Business Model Analysis

• 5.1 U.S. Pharmacy Benefit Management Business Model Market Share Analysis, 2022 & 2030
• 5.2 U.S. Pharmacy Benefit Management Business Model Market: Segment Dashboard
• 5.3 Market Size & Forecasts and Trend Analyses, 2017 to 2030 for the Business Model Segment
  • 5.3.1 Standalone PBM
    • 5.3.1.1 Standalone PBM market, 2017 - 2030 (USD Billion)
  • 5.3.2 Health Insurance Providers
    • 5.3.2.1 Health insurance providers market, 2017 - 2030 (USD Billion)
  • 5.3.3 Retail Pharmacy
    • 5.3.3.1 Retail pharmacy market, 2017 - 2030 (USD Billion)

Chapter 6 U.S. Pharmacy Benefit Management Market: End - use Analysis

• 6.1 U.S. Pharmacy Benefit Management End - use Market Share Analysis, 2022 & 2030
• 6.2 U.S. Pharmacy Benefit Management End - use Market: Segment Dashboard
• 6.3 Market Size & Forecasts and Trend Analyses, 2017 to 2030 for the End - use Segment
  • 6.3.1 Commercial
    • 6.3.1.1 Commercial market, 2017 - 2030 (USD Billion)
  • 6.3.2 Federal
    • 6.3.2.1 Federal market, 2017 - 2030 (USD Billion)

Chapter 7 Competitive Analysis

• 7.1 Recent Developments & Impact Analysis, by Key Market Participants
• 7.2 Competition Categorization (Key innovators, Market leaders, Emerging Players
• 7.3 Company Market Position Analysis
• 7.4 Company Profiles
  • 7.4.1 CVS HEALTH
    • 7.4.1.1 Company overview
    • 7.4.1.2 Financial performance
    • 7.4.1.3 Service benchmarking
    • 7.4.1.4 Strategic initiatives
  • 7.4.2 Elixir Rx Solutions LLC
    • 7.4.2.1 Company overview
    • 7.4.2.2 Service benchmarking
    • 7.4.2.3 Strategic initiatives
  • 7.4.3 Optum, Inc
    • 7.4.3.1 Company overview
    • 7.4.3.2 Financial performance
    • 7.4.3.2 Service benchmarking
    • 7.4.3.3 Strategic initiatives
  • 7.4.4 Cigna
    • 7.4.4.1 Company overview
    • 7.4.4.2 Financial performance
    • 7.4.4.2 Service benchmarking
    • 7.4.4.3 Strategic initiatives
  • 7.4.5 Change Healthcare
    • 7.4.5.1 Company overview
    • 7.4.5.2 Service benchmarking
    • 7.4.5.3 Strategic initiatives
  • 7.4.6 MedImpact
    • 7.4.6.1 Company overview
    • 7.4.6.2 Financial performance
    • 7.4.6.3 Service benchmarking
    • 7.4.6.4 Strategic initiatives
  • 7.4.7 Prime Therapeutics LLC
    • 7.4.7.1 Company overview
    • 7.4.7.2 Service benchmarking
    • 7.4.7.3 Strategic initiatives
  • 7.4.8 HUB International Limited.
    • 7.4.8.1 Company overview
    • 7.4.8.2 Service benchmarking
    • 7.4.8.3 Strategic initiatives
  • 7.4.9 Anthem
    • 7.4.9.1 Company overview
    • 7.4.9.2 Financial performance
    • 7.4.9.3 Service benchmarking
    • 7.4.9.4 Strategic initiatives