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Pharmacy Benefit Trends and Data

About This Resource

Available Format(s):
Print with CD

Date: Copyright 2009

Table of Contents
Data Fields
Written By
Written For
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Pub Code: GDRU8
Pages: 280
ISBN: 1-933801-71-9

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2000-2009 Survey Results
Pharmacy Benefit Trends and Data:
Costs, Benefit Design, Utilization, PBM Market Share

Pharmacy Benefit Trends and Data provides PBM data gathered from AIS’s quarterly surveys to help you determine how successful PBMs have been in stabilizing or decreasing prescription drug utilization and drug spend — and also see what pharmacy benefit management trends are on the horizon. With stats by company and by aggregated numbers, Pharmacy Benefit Trends and Data reports the top benchmarks on the entire books of business for PBMs:
 
  • Prescription volume
  • Drug spend
  • Covered lives
  • Annual gross revenues
  • Mail order market share
  • And much more.
 

Order Now Print Version with Accompanying CD $1,275

This edition of Pharmacy Benefit Trends and Data captures membership and market share data from Q2-2000 until Q2-2009. That’s 37 surveys over ten years, resulting in a book featuring hundreds of pages of data in tables, graphs and charts, plus an accompanying CD with raw data in Excel spreadsheets.

Managing drug costs has become an even higher priority for health plans as the Rx benefit has come to represent a larger and larger portion of outpatient health care expenses, and the role of PBMs has become increasingly more vital. The data in Pharmacy Benefit Trends and Data can help you:

  • Discover where there’s an opportunity for cost containment by looking at average ingredient costs, dispensing fees and actual amounts paid.
  • Determine the point at which the copay differential (the price difference between one tier and the next) actively influences consumer behavior.
  • Evaluate formulary structure by looking at the average number of drugs, broken down into brand (both single- and multi-source) and generic (MAC and non-MAC), as well as lives covered by formulary.
  • Identify the most widely utilized prescription products at each PBM.
  • Analyze utilization volume by benefit tier.
  • Develop projections about the effect of a slight decrease in prescription volume on the overall growth trend.
  • Analyze drug spend by 11 top therapeutic categories and see which areas have had the biggest shifts.

Pharmacy Benefit Trends and Data is a resource that consists of both a printed book and an accompanying CD with all of the book’s data — plus additional data not contained in the book — in easy-to-use Excel spreadsheets. It also contains a directory of PBMs, PBAs, SPPs and related companies with contact information, key executives and business volume indicators, such as revenue, number of clients and total Rx per year.

With company-specific data, notations on mergers, consolidations and acquisitions, and brief company histories, Pharmacy Benefit Trends and Data helps you develop insight into the influence of smaller PBM entities on the industry, as well as discern the impact of “captive” PBMs, which represent their parent company’s interests before their own profit motive.

Order Now Print Version with Accompanying CD $1,275

Table of Contents

Chapter 1: PBM Drug Spend by Therapeutic Category

  • Methodology
  • Percentage of Total Annual PBM Drug Spend for Top Therapeutic Categories
  • Estimated Annual PBM Drug Spend for Top Therapeutic Categories
  • Trend and Spend for Specific Therapeutic Categories

Chapter 2: Prescription Drug Costs Per Prescription, By Cost Component, Brand and Generic

  • Methodology
  • Ingredient Costs
  • Dispensing Fees
  • Actual Amount Paid per Rx
  • Comparisons and Analysis

Chapter 3: Benefit Design Trends

  • Methodology and Overview
  • Copay Amounts
  • Tiered Copay Structures
  • Formulary Design

Chapter 4: PBM Membership and Market Share

Chapter 5: PBM Prescription Volume and Mail-Order Growth

  • Methodology
  • Total Claims Processed by PBMs
  • Prescription Volume by Sales Outlet — Retail, Mail, Specialty
  • Mail Order Rx Utilization

Chapter 6: Evaluating Market Share by Different Business Volume Metrics

  • Methodology
  • Market Share by Covered Lives/Membership
  • Market Share by Prescription Volume
  • Mail-Order Market Share
  • Market Share by Annual Drug Spend
  • Market Share by Annual Gross Revenues

Chapter 7: Prescription Drug Utilization by Tier

  • Claims Processed by Tier
  • Claims per Tier for Leading PBMs and PBAs, as of 2Q2009
  • Utilization by Product
  • Generic Fill Rate

Chapter 8: PBM Drug Spend and Revenue Data

  • Annual Drug Expenditure
  • Annual Gross Revenues

Chapter 9: Specialty Pharmacy Provider Data

  • Company Revenues From Specialty Pharmacy
  • Specialty Pharmacy Prescription Volume and Growth
  • Specialty Pharmacy Drug Spend
  • SPP Patients Served Annually

Chapter 10: AIS’s Quarterly Survey of PBMs, PBAs, SPPs and Related Companies, Raw Survey Data per Company

  • Raw Survey Results for 2nd Quarter 2000
  • Raw Survey Results for 2nd Quarter 2005
  • Raw Survey Results for 2nd Quarter 2009

Chapter 11: Evolution of the PBM Industry and Growth of Specific Companies

  • PBM Core Capabilities
  • Growth and Market Share of the Biggest PBM Consolidators

Chapter 12: Directory of PBMs, PBAs, SPPs and Related Companies

Appendix: AIS’s Quarterly Survey of PBMs, PBAs and Other Drug Benefit Vendors

Data Fields
  • Company Name
  • Annual Gross Revenues Total
    • Annual Gross Revenues PBM
    • Annual Gross Revenues SP
  • Number Employees PBM Operations
  • Number Employees in Specialty Pharmacy Operations
  • Drug Spend per Year in PBM Operations
  • Drug Spend per Year Specialty Operations
  • Number of Clients
    • Number MCO Clients
    • Number Physician Clients
  • % Private Sector Business
  • % Public Sector Business
  • Number SP Patients per Year
  • Total Covered Lives
  • Number of Lives Under Formulary Control
  • Number Prescriptions Per Year
    • Rx Via Retail Total
      • Rx Via Independent
      • Rx Via Chain
    • Rx Via Mail Order
    • Rx Via Specialty Pharmacy
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  • Number Pharmacies in Network
    • Total Retail Pharmacies
      • Independent Pharmacies
      • Chain Pharmacies
    • Mail-Order Pharmacies
      • Internet-Based Pharmacies
    • SP Distribution Centers
  • Number of Drugs in Formulary
    • Brand Name Total
      • Brand Name Single-Source
      • Brand Name Multi-Source
    • Generic
      • MAC
      • Non-MAC
  • Average Copay 1st Tier
  • Average Copay 2nd Tier
  • Average Copay 3rd Tier
  • % of Claims Processed at 1st Tier
  • % of Claims Processed at 2nd Tier
  • % of Claims Processed at 3rd Tier
Written By:

Pharmacy Benefit Trends and Data is published by Atlantic Information Services, Inc. (AIS). The surveys are conducted by in-house researchers who work exclusively for AIS.

Written For:

Professionals in these fields:

  • Pharmacy directors and pharmacists, pharmacy services managers
  • Chief medical officers and medical directors
  • Health plan executives and managed care directors
  • Benefit design and contracting managers, benefits administrators
  • Strategic planners, market researchers and business development managers
  • Analysts and actuaries
  • Sales and marketing directors 

Who work in these types of organizations:

  • PBMs, PBAs, SPPs
  • Pharmacies and drug stores
  • Pharmaceutical companies and manufacturers
  • Health plans
  • Pharmaceutical research organizations
  • Health systems and medical centers
  • Financial and investment firms
  • Consulting firms
  • Large-scale employers 
Shipping Information

This item is shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes.) You should receive your order within 5-7 business days. Shipping cost is $5 per item.

Rush orders: Please call us at 800-521-4323 to place a rush order. We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.

AIS’s Satisfaction Guarantee

Order Pharmacy Benefit Trends and Data for a 30-day risk-free inspection and test for yourself the value of this data and analysis resource. If within 30 days you’re not interested, just return it to AIS and we will send you a prompt, full refund. Please review your copy of the print version before breaking the seal on the CD package. Refunds will not be made once the seal on the CD package has been broken.

Related Publications

Drug Benefit News
Specialty Pharmacy: Stakeholders, Strategies and Markets
Specialty Pharmacy News
Health Plan Week
AIS’s Directory of Health Plans

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