US Drug Utilization Management Market Report to Analyze Size, Share and Trends 2024-2030 with Key Internal and External Vendors

US Drug Utilization Management Market

Dublin, Aug. 19, 2024 (GLOBE NEWSWIRE) — The report “US Drug Utilization Management Market Size, Share & Trends Analysis Report by Program Type (In-House, Outsourced), End-use (PBMs, Health Plan Providers/Payors, Pharmacies) and Segment Forecasts, 2024-2030” has been added to The Offer.

The US medication utilization management market is expected to reach $60.68 billion by 2030, growing at a compound annual growth rate (CAGR) of 7.30% from 2024 to 2030.

The market growth is mainly due to the increasing introduction of innovative but high-cost drugs. This leads to payers trying to keep spending under control and pharmaceutical manufacturers trying to support patient access to medicines and sales.

Payers are implementing strategies such as restricting drug lists, strict approval requirements, and higher patient cost-sharing obligations, while manufacturers are investing in programs to help patients and physicians navigate administrative controls and meet their cost-sharing obligations.

As expensive medications become more widely used and insurance companies use utilization management to control costs by influencing patient care decisions, the need for PA is expected to increase in the coming years. According to a 2022 study published by the National Library of Medicine, PA and other utilization management tools impact a significant portion of prescriptions, with physicians processing an average of 19.7 PAs per week. These tools, including drug list restrictions and step edits, are critical to managing patient care decisions and optimizing outcomes.

In addition, the increasing integration of real-time data analytics into medication utilization management offers significant opportunities to improve efficiency and reduce costs in the healthcare sector. Real-time analytics platforms such as Xevant and MaxCare RX provide insights into prescription drug usage, cost trends, and emerging patterns, empowering decision makers with actionable information.

These tools enable pharmacy benefit professionals to optimize pharmacy spend, evaluate data analytics trends, and access real-time information and alerts, ultimately leading to lower costs and improved health outcomes. Therefore, this advancement in integrating real-time data analytics into pharmacy utilization management is expected to drive the growth of the U.S. drug utilization management market in the coming years.

Highlights of the US Drug Utilization Management Market Report

• Based on program type, the in-house segment dominated the market with the largest revenue share in 2023, due to the increasing prevalence of chronic diseases that require effective management of medication intake.

• Based on end use, the PBM segment dominated the market with the largest revenue share in 2023 and is also expected to witness the fastest growth during the forecast period. The growth of the segment is mainly driven by the growing demand for specialty pharmacy services.

• In February 2024, Point32Health, a leading nonprofit health and wellness organization, signed an agreement to acquire Health New England, a subsidiary of Baystate Health.

• In October 2021, a nonprofit partnership of about 40 private employers, including Costco and Walmart, formed EmsanaRx, a new company that offers PBM services to employers.

The story continues

Company Profiles: Third Party Providers

• Prime Therapeutics LLC

• MedicusRx

• EmblemHealth

• Optum, Inc.

• Point32Health, Inc.

• AssureCare LLC

• MindRx Group

• Agadia Systems, Inc

• Elevance Health (CarelonRx)

• ExlService Holdings, Inc.

• Magnetic resonance imaging (MRIoA)

• S&C Technologies, Inc.

Company profiles: In-house providers

• Ultimate Health Plans

• Safety Health Plan of Wisconsin, Inc.

• Blue Cross and Blue Shield Association

• providence

• Simply Healthcare Plans, Inc

• San Mateo Health Plan (HPSM)

• PerformRx

• Aetna, Inc. (CVS Health Corp.)

Main features:

Main topics covered:

Chapter 1. Methodology and scope

Chapter 2. Summary
2.1. Market overview
2.2. Segment Snapshot
2.3. Overview of the competitive landscape

Chapter 3. Market variables, trends and scope
3.1. Market outlook
3.2. Market trends and outlook
3.3. Market dynamics
3.3.1. Market driver analysis
3.3.1.1. Increasing demand for automated usage management systems
3.3.1.2. Need to improve prescription patterns for specialty medicines
3.3.1.3. Growing demand for cost containment in the healthcare system
3.3.2. Market restriction analysis
3.3.2.1. Regulatory and data protection issues
3.3.2.2. Lack of transparency
3.3.3. Industry opportunity analysis
3.3.3.1. Increasing integration of real-time data analytics in healthcare
3.3.4. Analysis of industry challenges
3.3.4.1. Delayed access to treatment and obstruction of medication use
3.4. Qualitative analysis: price analysis in drug utilization management
3.5. Tools for analyzing the business environment
3.5.1. Industry analysis – Porter’s Five Forces Analysis
3.5.2. PESTEL analysis

Chapter 4. US Drug Utilization Management Market, by Program Type, 2018-2030 (USD Billion)
4.1. US Drug Utilization Management Market: Program Type Segment Dashboard
4.2. Programme type movement and market share analysis, 2023 and 2030
4.3. US Drug Utilization Management Market Size and Forecast by Program Type, 2018-2030 (USD Billion)
4.4. In-House
4.5. Outsourced

Chapter 5. US Drug Utilization Management Market, by End Use, 2018-2030 (USD Billion)
5.1. US Drug Utilization Management Market: End-Use Segment Dashboard
5.2. End-user movement and market share analysis, 2023 and 2030
5.3. US Drug Utilization Management Market Size and Forecast by End-Use (USD Billion)
5.4. PBMs
5.5. Health insurance providers/payers
5.6. Pharmacies

Chapter 6. Competitive landscape
6.1. Participant categorization
6.2. Analysis of the company’s market position
6.3. Strategy planning
6.3.1. Extension
6.3.2. Merger and acquisition
6.3.3. Partnerships/Cooperations/Alliances
6.3.4. Miscellaneous

For more information about this report visit https://www.researchandmarkets.com/r/gb1c9v

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