In an article by Qato et al. (2024), the diploma of market focus within the discipline of pharmacy advantages managers (PBMs) is quantified.

The PBM market was extremely concentrated throughout all payer varieties, with an HHI [Herfindahl Hirschman Index (HHI)] from 1972…the HHI was lowest in industrial insurance coverage (1,940), with 90 PBM contributors, and highest in Medicare Half D (2,399), with 21 PBM contributors.

Three PBMs dominate in nearly all markets. These three main PBMs (CVS Caremark, Optum Rx, and Categorical Scripts) account for 73.6% of retail prescriptions stuffed. This varies by payer sort.

… CVS Caremark alone accounted for 39.2% of PBM companies within the Medicaid managed care market, 28.5% in industrial markets, and 33.4% in Medicare Half D, whereas Categorical Scripts accounted for 28.0% of the industrial market, about double its share in Medicaid (12.3%) and Medicare Half D (15.4%). Optum Rx and SS&C Well being accounted for a bigger share of the Medicare Half D market (27.7% and 16.2%, respectively) in comparison with industrial (16.4% and a couple of.9%) or Medicaid (15.8% and 1.2%) markets.

You’ll be able to learn the complete article right here.