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Pharmacy benefit managers (PBMs)

Statistics report on pharmacy benefit managers in the United States

This report provides an overview of the pharmacy benefit management (PBM) landscape in the United States. Included within are statistics and facts on the largest PBMs, their role in the U.S. pharmaceutcial market, problems with drug exclusions, as well as the public opinion about PBMs.

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Table of contents

Overview

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  • Premium Statistic U.S. net medicine spending 2015-2030
  • Premium Statistic Pharmacy benefit management market forecast worldwide 2029
  • Basic Statistic Distribution of Rx drug dollar spending among supply chain participants U.S. 2023
  • Premium Statistic Number of Americans served by PBMs by insurance type 2023
  • Basic Statistic Market access rebates and discounts for brand medicines by component U.S. 2013-2020

Major players

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  • Premium Statistic U.S. prescription market: market share of pharmacy benefit managers 2023-2025
  • Basic Statistic CVS Health's revenue 2010-2023 by segment
  • Premium Statistic Segment revenues of Cigna 2019-2025
  • Premium Statistic Revenues generated by Optum 2013-2025, by business
  • Basic Statistic Market share of the largest pharmacy benefit manager by U.S. state 2022

PBMs' view: savings

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  • Basic Statistic Amount saved by PBMs per person by payer U.S. 2022
  • Basic Statistic Amount saved by PBMs annually per person by approach U.S. 2022
  • Premium Statistic Average additional saving by PBMs in the U.S. by saving category 2023
  • Premium Statistic Projected PBM savings in the U.S. 2023-2032, by payer

External criticism: exclusions

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  • Basic Statistic Rx medicine exclusion from U.S. pharmacy formularies by company 2014-2025
  • Basic Statistic Rx medicine exclusion from PBM formularies 2014-2022
  • Basic Statistic Rx medicine exclusion growth rate from PBM formularies 2015-2022
  • Basic Statistic Rx medicine exclusion from PBM formularies by therapy area 2014-2022

Public opinion

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  • Premium Statistic Select concerns among Americans regarding pharmacy benefit managers 2023
  • Basic Statistic Americans' concerns regarding PBM overcharging by party affiliation 2023
  • Basic Statistic Concerns about middlemen holding medicines from patients by party affiliation 2023
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