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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. [ 1][ 2] PBMs operate inside of ...
US$ 226.6 billion (2023) [ 1] Parent. UnitedHealth Group. Website. www .optum .com /en /. Optum, Inc. is an American healthcare company that provides technology services, pharmacy care services (including a pharmacy benefit manager) and various direct healthcare services. Optum was formed as a subsidiary of UnitedHealth Group in 2011 by merging ...
Express Scripts began in 1986 in St. Louis County, Missouri as a result of a joint venture between a retail chain of more than 79 pharmacies (Medicare Glaser Inc.) and Sanus Corp. Health Systems. Sanus traces its history to Bradford Systems and Administrative Services which was founded in Boston in 1968.
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.
The Optum contracts, signed in 2015, contributed 16% of Cardinal's total revenue in fiscal year 2023, but the bulk of the shipments mainly comprised non-specialty medicines, Cardinal Health said.
There are approximately 88,000 pharmacies in the United States. Over half (about 48,000) are located within drug stores, grocery stores, hospitals, department stores, medical clinics, surgery clinics, universities, nursing homes, prisons, and other facilities. The remaining pharmacies are considered to be independent or privately owned.
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Specialty pharmacy refers to distribution channels designed to handle specialty drugs — pharmaceutical therapies that are either high cost, [1] [2] [3] high complexity [3] and/or high touch. [2] High touch refers to higher degree of complexity in terms of distribution, administration, or patient management which drives up the cost of the drugs.
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