Healthcare Finance News September 10, 2024
The analysis also finds a high prevalence of vertical integration of PBMs with health insurance companies.
Newly published data suggests low competition among middling players in the pharmaceutical supply chain, with numbers showing that the four largest pharmacy benefit managers in the country control roughly 70% of the national market.
The American Medical Association analysis, based on 2022 data on commercial and Medicare Part D prescription drug plan (PDP) enrollees, also found a high prevalence of vertical integration of PBMs with health insurance companies.
CVS Health is the largest PBM (with a 21.3% market share), followed by OptumRx (20.8%), Express Scripts (17.1%) and Prime Therapeutics (10.3%).
At the local level, the average PBM market is highly concentrated when measured against...
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