Table of Content

1 Research Methodology

2 Research Objectives

3 Research Process


4 Scope & Coverage
4.1 Market Definition
4.1.1 Inclusion
4.1.2 Exclusion
4.2 Base Year
4.3 Scope Of The Study
4.4 Market Segments
4.4.1 Market Segmentation By Service
4.4.2 Market Segmentation By Health Plan
4.4.3 Market Segmentation By Business Model


5 Report Assumptions & Caveats
5.1 Key Caveats
5.2 Currency Conversion
5.3 Market Derivation


6 Market at a Glance

7 Introduction
7.1 State of the US Economy and healthcare industry
7.2 Pharmacy Benefits Management
7.2.1 Benefits
7.2.2 Value Chain
7.2.3 PBM Financial Arrangements
7.2.4 Success Factors


8 Growth Opportunities & Trends
8.1 Foray into Digital Health Solutions
8.2 Shift to Value / Outcomes-based Contracts
8.3 Move Away From a Standalone Mentality
8.4 Increased Engagement in High-Touch Care Management


9 Market Growth Enablers
9.1 Gaps in Information and Care in the Healthcare Industry
9.2 Growth in FDA Approvals for Orphan and Specialty Drugs
9.3 Prevalence of Fraud, Waste, and Abuse in Healthcare
9.4 Shift Towards Individualized Medicines


10 Market Restraints
10.1 PBMs Maligned And Scrutinized For Pricing
10.2 Declining Growth From Generics
10.3 Legal Uncertainty & Impending Limitations On PBM Tools
10.4 Significant Delays Cause Dissatisfaction


11 Market Landscape
11.1 Market Size & Forecast
11.2 Five Forces Analysis
11.2.1 Threat of New Entrants
11.2.2 Bargaining Power of Suppliers
11.2.3 Bargaining Power of Buyers
11.2.4 Threat of Substitutes
11.2.5 Competitive Rivalry


12 Service
12.1 Market Snapshot & Growth Engine
12.2 Market Overview
12.3 Specialty Pharmacy Services
12.3.1 Market Size & Forecast
12.4 Retail Pharmacy Services
12.4.1 Market Size & Forecast
12.5 Mail-order Pharmacy Services
12.5.1 Market Size & Forecast
12.6 Benefit Plan Design and Administration
12.6.1 Market Size & Forecast
12.7 Formulary Management
12.7.1 Market Size & Forecast
12.8 Clinical Programs and Services
12.8.1 Market Size & Forecast
12.9 Others
12.9.1 Market Size & Forecast


13 Health Plan
13.1 Market Snapshot & Growth Engine
13.2 Market Overview
13.3 Commercial Health Plans
13.3.1 Market Size & Forecast
13.4 Medicare Part D Plans
13.4.1 Market Size & Forecast
13.5 Self-insured Health Plans
13.5.1 Market Size & Forecast
13.6 Managed Medicaid Programs
13.6.1 Market Size & Forecast
13.7 Others
13.7.1 Market Size & Forecast


14 Business Model
14.1 Market Snapshot & Growth Engine
14.2 Market Overview
14.3 Insurance Companies and Retail Pharmacies
14.3.1 Market Size & Forecast
14.4 Pure Play PBMs
14.4.1 Market Size & Forecast


15 Competitive Landscape
15.1 Competitive Scenario


16 Market Vendor Analysis
16.1 Market Ranking Analysis


17 Key Company Profiles
17.1 CVS Caremark
17.1.1 Business Overview
17.1.2 Major Service Offerings
17.1.3 Key Strengths
17.1.4 Key Strategies
17.1.5 Key Opportunity
17.2 EXPRESS SCRIPTS
17.2.1 Business Overview
17.2.2 Major Service Offerings
17.2.3 Key Strengths
17.2.4 Key Strategies
17.2.5 Key Opportunity
17.3 OPTUMRX
17.3.1 Business Overview
17.3.2 Major Service Offerings
17.3.3 Key Strength
17.3.4 Key Strategies
17.3.5 Key Opportunity
17.4 Humana Pharmacy Solutions
17.4.1 Business Overview
17.4.2 Major Service Offerings
17.4.3 Key Strengths
17.4.4 Key Strategies
17.4.5 Key Opportunity


18 Other Prominent Vendors
18.1 Abarca Health
18.1.1 Business Overview
18.1.2 Service Offerings
18.1.3 Key Strengths
18.1.4 Key Strategies
18.2 Anthem
18.2.1 Business Overview
18.2.2 Service Offerings
18.2.3 Key Strengths
18.2.4 Key Strategies
18.3 Ascella Health
18.3.1 Business Overview
18.3.2 Service Offerings
18.3.3 Key Strengths
18.3.4 Key Strategies
18.4 BeneCard PBF
18.4.1 Business Overview
18.4.2 Service Offerings
18.4.3 Key Strengths
18.4.4 Key Strategies
18.5 Centene
18.5.1 Business Overview
18.5.2 Service Offerings
18.5.3 Key Strengths
18.5.4 Key Strategies
18.6 Citizens Rx
18.6.1 Business Overview
18.6.2 Service Offerings
18.6.3 Key Strengths
18.6.4 Key Strategies
18.7 EnvisionRxOptions
18.7.1 Business Overview
18.7.2 Service Offerings
18.7.3 Key Strengths
18.7.4 Key Strategies
18.8 Excelera
18.8.1 Business Overview
18.8.2 Service Offerings
18.8.3 Key Strengths
18.8.4 Key Strategies
18.9 Magellan Rx Management
18.9.1 Business Overview
18.9.2 Service Offerings
18.9.3 Key Strengths
18.9.4 Key Strategies
18.10 MedalistRx
18.10.1 Business Overview
18.10.2 Service Offerings
18.10.3 Key Strength
18.10.4 Key Strategies
18.11 MedImpact Healthcare Systems
18.11.1 Business Overview
18.11.2 Service Offerings
18.11.3 Key Strengths
18.11.4 Key Strategies
18.12 Prime Therapeutics
18.12.1 Business Overview
18.12.2 Service Offerings
18.12.3 Key Strengths
18.12.4 Key Strategies
18.13 MaxorPlus
18.13.1 Business Overview
18.13.2 Service Offerings
18.13.3 Key Strengths
18.13.4 Key Strategies
18.14 Navitus Health Solutions
18.14.1 Business Overview
18.14.2 Service Offerings
18.14.3 Key Strength
18.14.4 Key Strategy
18.15 Perform Rx
18.15.1 Business Overview
18.15.2 Service Offerings
18.15.3 Key Strengths
18.15.4 Key Strategies
18.16 RxAdvance
18.16.1 Business Overview
18.16.2 Service Offerings
18.16.3 Key Strengths
18.16.4 Key Strategies
18.17 WellDyne RX
18.17.1 Business Overview
18.17.2 Service Offerings
18.17.3 Key Strengths
18.17.4 Key Strategies


19 Report Summary
19.1 Key Takeaways
19.2 Strategic Recommendations


20 Quantitative Summary
20.1 Market By Service
20.2 Market BY Health Plan
20.1 Market By Business Model

21 Appendix
21.1 Abbreviations