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Three companies controlled 79% of U.S. pharmacy benefit management in 2022, according to the data platform Statista: CVS Caremark with 33%, Express Scripts at 24%, and OptumRx owns 22% of the market.
Pharmacy benefit management. In the United States, a pharmacy benefit manager ( PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.
4,439 (2022) [1] Website. cambiahealth.com. Cambia Health Solutions is a nonprofit health care company based in Portland, Oregon. [2] It is the parent company of Regence, a member of the Blue Cross Blue Shield Association operating in Oregon, Idaho, Utah, and Washington; Asuris Northwest Health; BridgeSpan Health; and LifeMap.
Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2] Express Scripts had 2016 revenues of $100.752 billion. [2]
The three biggest pharmacy benefit managers excluded 1,356 medications for at least a year from 2019 to 2022, according to a Pembroke Consulting study. Prior authorization, step therapy and exclusions
Medco Health Solutions, Inc. was an American Pharmacy Benefits Management (PBM) company. Medco provided pharmacy services to private and public employers, health plans, labor unions, government agencies, and individuals served by Medicare Part D Prescription Drug Plans. Medco was a member of the S&P 500 and ranked number 34 on the 2011 Fortune ...
CVS Caremark has been aggressively trying to grow its pharmacy-benefits-management business after suffering from some major setbacks in 2009-2010. High-profile contracts from CalPERS, Medco Health ...
The 340B Drug Pricing Program is a US federal government program created in 1992 that requires drug manufacturers to provide outpatient drugs to eligible health care organizations and covered entities at significantly reduced prices. The intent of the program is to allow covered entities to "stretch scarce federal resources as far as possible ...