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Who is the largest pharmacy benefit manager?

Here are the biggest PBMs by 2022 market share, ing to Drug Channels: CVS Health / Caremark: 33 percent. Cigna / Evernorth / Express Scripts: 24 percent. UnitedHealth / OptumRx: 22 percent. Humana Pharmacy Solutions: 8 percent. Prime Therapeutics / Magellan Rx: 5 percent. MedImpact Healthcare Systems: 4 percent.

What is the controversy with pharmacy benefit managers?

The PBM provides 5 key functions: formulary design, utilization management, price negotiation, pharmacy network formation, and mail order pharmacy services. Criticism of the PBM industry centers around the lack of competition, pricing, agency problems, and lack of transparency.

Who is the largest PBM?

By almost any measure, the pharmacy benefit management (PBM) business is one dominated by the major players. In 2021, CVS Caremark led the industry, controlling 34% of total adjusted claims, followed by Express Scripts (25%) and Optum Rx (21%).

Who are the three big PBM?

For 2024, the three largest pharmacy benefit managers (PBMs)Caremark (CVS Health), Express Scripts (Cigna), and OptumRx (United Health Group)have again each excluded 600 or more drugs from their standard formularies.

Who are the Big 3 PBM?

To understand how three PBMs (Express Scripts, CVS Caremark, and Optum Rx) came to command such a massive chunk of a huge market, we need to look back at the origin of the industry.

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