Press Release

The U.S. Pharmacy Benefit Management Market, 30% of Industry Growth originated from Southern U.S.


According to the latest focus insight report by Arizton, the U.S. pharmacy benefit management (PBM) market 2024 – 2029 sheds light on the dynamic and rapidly evolving industry. The comprehensive report unveils valuable market trends, growth opportunities, and the competitive landscape of the business. With in-depth analysis and meticulous research, this report serves as a strategic guide for industry players, investors, and decision-makers, offering a comprehensive understanding of the current U.S. pharmacy benefit management (PBM) market dynamics and prospects.

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The U.S. pharmacy benefit management (PBM) market was valued at $491.88 billion in 2023 and is expected to reach $680.73 billion by 2029, growing at a CAGR of 5.56% during the forecast period. The demand for pharmacy benefit management is rising due to multiple factors, including the rising baby boomers, the rising aging population, the increase in healthcare expenditure, the growing prevalence of heart diseases and nerve disorders, and the growing awareness among the general population.

Healthcare expenditure in the U.S. is high due to the high cost of medicine. The U.S. is one of the countries with the most expensive healthcare systems globally. There is a high demand for health plans.

The Medicare Plan Generated $454 Billion in 2023, Driving the Market Growth

The medicare plan of health plan segment is growing significantly, with the fastest-growing CAGR of 6.74% during the forecast period. The growth of this segment is attributed to several factors, which include a shift towards virtual care delivery, more home care, and the adoption of value-based care models. According to the new prescription drug law, drug companies must now pay rebates to Medicare when their prescription drug prices increase faster than the rate of inflation for certain drugs dispensed to people with Medicare. It is observed that in 2023, 30.8 million people will be enrolled in a Medicare Advantage plan, accounting for more than half, or 51%, of the eligible Medicare population and $454 billion (or 54%) of total federal Medicare spending.

The South Region Dominated the Segment with a 30% Market Share in 2023

The southern states in the US have the highest number of adults who skip care due to the cost and some of the maximum rates of uninsured people. Kentucky, West Virginia, Virginia, and Louisiana are the top states with a high percentage of insurers among the southern states in the U.S. It is observed that 90% of the total population is insured by government or non-government firms. With its recent adoption of the Affordable Care Act (ACA) Medicaid expansion to adults, Louisiana became the 32nd state to move forward with the expansion and the 7th of the 17 states that make up the American South to expand. Within the South, which has high rates of chronic disease and poor health outcomes, most states still have not adopted the Medicaid expansion. Overall, one in five (20%) adults in the South report fair or poor health status, compared to 16% of adults in the Midwest and Northeast and 17% in the West. According to the U.S. census, it is observed that the infant mortality rate in the South is higher compared to that in the other regions. The South also has a higher rate of cancer-related deaths compared to the Northeast and West.

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