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In 2025, the top pharmacy benefit managers included Cigna, CVS Health, and OptumRx, to name the most important. Cigna had the largest share of the pharmacy benefit manager market in that year, holding ** percent of the market. Pharmacy benefit managers are an influential part of the prescription drug supply chain in the United States. 

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 the processing of insurance claims from patients and pharmacies. Among pharmaceutical distributors in the U.S., chain stores distributed the largest value of pharmaceuticals recently. However, data suggest that pharmacy benefit managers have the highest gross profit among all actors in the U.S. drug supply chain.

Generic drugs

Lately, 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 has recently been on the rise. Generic drugs are useful to the consumer in that, in many cases, they provide a cheaper alternative to brand-name drugs.