U.S. Drug Utilization Management Market Size, Share & Trends Analysis Report By Program Type (In-house, Outsourced), By End-use (PBMs, Health Plan Providers/Payors, Pharmacies), And Segment Forecasts, 2025 - 2033

Table of Contents

Chapter 1. Methodology and Scope

• 1.1. Market Segmentation & Scope
  • 1.1.1. Estimates and Forecast Timeline
• 1.2. Market Definitions
  • 1.2.1. Segment definitions.
    • 1.2.1.1. Program type
    • 1.2.1.2. End use
• 1.3. Research Methodology
• 1.4. Information Procurement
  • 1.4.1. Purchased Database
  • 1.4.2. GVR's Internal Database
  • 1.4.3. Secondary Sources
  • 1.4.4. Primary Research
    • 1.4.4.1. Details of Primary Research
  • 1.4.5. Research Assumption
• 1.5. Information or Data Analysis
  • 1.5.1. Data Analysis Models
• 1.6. Market Formulation & Data Visualization
• 1.7. Model Details
  • 1.7.1. Volume Price Analysis
  • 1.7.2. Segment-level market estimation: Multivariate analysis
  • 1.7.3. Multivariate analysis
  • 1.7.4. Forecast & CAGR Calculation
• 1.8. Objectives
• 1.9. List of Secondary Sources
• 1.10. List of Abbreviations

Chapter 2. Executive Summary

• 2.1. Market Snapshot
• 2.2. Segment Snapshot
• 2.3. Competitive Landscape Snapshot

Chapter 3. Market Variables, Trends, & Scope

• 3.1. Market Lineage 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 utilization management systems
    • 3.3.1.2. Need for improving prescription patterns for specialty drugs
    • 3.3.1.3. Growing demand for cost containment in the healthcare industry
  • 3.3.2. Market Restraint Analysis
    • 3.3.2.1. Regulatory and privacy issues
    • 3.3.2.2. Lack of transparency
  • 3.3.3. Industry Opportunity Analysis
    • 3.3.3.1. Growing integration of real-time data analytics in the healthcare industry
  • 3.3.4. Industry Challenges Analysis
    • 3.3.4.1. Delayed access to treatment and hindrance in medication adherence
• 3.4. Qualitative Analysis: Pricing Analysis on Drug Utilization Management
• 3.5. Business Environment Analysis Tools
  • 3.5.1. Industry Analysis - Porter's Five Forces Analysis
    • 3.5.1.1. Supplier power
    • 3.5.1.2. Buyer power
    • 3.5.1.3. Substitution threat
    • 3.5.1.4. Threat of new entrant
    • 3.5.1.5. Competitive rivalry
  • 3.5.2. PESTEL Analysis

Chapter 4. U.S. Drug Utilization Management Market, By Program Type, 2021 - 2033 (USD Billion)

• 4.1. U.S. Drug Utilization Management Market: Program Type Segment Dashboard
• 4.2. Program Type Movement & Market Share Analysis, 2024 & 2033
• 4.3. U.S. Drug Utilization Management Market Size & Forecast and Forecasts, By Program Type, 2021 - 2033 (USD Billion)
• 4.4. In-House
  • 4.4.1. In-house market, 2021 - 2033 (USD Billion)
• 4.5. Outsourced
  • 4.5.1. Outsourced - market, 2021 - 2033 (USD Billion)

Chapter 5. U.S. Drug Utilization Management Market, By End Use, 2021 - 2033 (USD Billion)

• 5.1. U.S. Drug Utilization Management Market: End Use Segment Dashboard
• 5.2. End Use Movement & Market Share Analysis, 2024 & 2033
• 5.3. U.S. Drug Utilization Management Market Size & Forecast and Forecasts, By End Use (USD Billion)
• 5.4. PBMs
  • 5.4.1. PBMs market, 2021 - 2033 (USD Billion)
• 5.5. Health Plan Provider/Payors
  • 5.5.1. Health Plan Provider/Payors market, 2021 - 2033 (USD Billion)
• 5.6. Pharmacies
  • 5.6.1. Pharmacies market, 2021 - 2033 (USD Billion)

Chapter 6. Competitive Landscape

• 6.1. Participant Categorization
• 6.2. Company Market Position Analysis
• 6.3. Strategy Mapping
  • 6.3.1. Expansion
  • 6.3.2. Merger and Acquisition
  • 6.3.3. Partnership/Collaborations/Alliances
  • 6.3.4. Others
• 6.4. Company Profiles: Third-Party Providers
  • 6.4.1. Prime Therapeutics LLC
    • 6.4.1.1. Overview
    • 6.4.1.2. Financial Performance
    • 6.4.1.3. Service Benchmarking
    • 6.4.1.4. Strategic Initiatives
  • 6.4.2. MedicusRx
    • 6.4.2.1. Overview
    • 6.4.2.2. Financial Performance
    • 6.4.2.3. Service Benchmarking
    • 6.4.2.4. Strategic Initiatives
  • 6.4.3. EmblemHealth
    • 6.4.3.1. Overview
    • 6.4.3.2. Financial Performance
    • 6.4.3.3. Service Benchmarking
    • 6.4.3.4. Strategic Initiatives
  • 6.4.4. Optum, Inc.
    • 6.4.4.1. Overview
    • 6.4.4.2. Financial Performance
    • 6.4.4.3. Service Benchmarking
    • 6.4.4.4. Strategic Initiatives
  • 6.4.5. Point32Health, Inc.
    • 6.4.5.1. Overview
    • 6.4.5.2. Financial Performance
    • 6.4.5.3. Service Benchmarking
    • 6.4.5.4. Strategic Initiatives
  • 6.4.6. AssureCare LLC
    • 6.4.6.1. Overview
    • 6.4.6.2. Financial Performance
    • 6.4.6.3. Service Benchmarking
    • 6.4.6.4. Strategic Initiatives
  • 6.4.7. MindRx Group
    • 6.4.7.1. Overview
    • 6.4.7.2. Financial Performance
    • 6.4.7.3. Service Benchmarking
    • 6.4.7.4. Strategic Initiatives
  • 6.4.8. Agadia Systems, Inc
    • 6.4.8.1. Overview
    • 6.4.8.2. Financial Performance
    • 6.4.8.3. Service Benchmarking
    • 6.4.8.4. Strategic Initiatives
  • 6.4.9. Elevance Health (CarelonRx)
    • 6.4.9.1. Overview
    • 6.4.9.2. Financial Performance
    • 6.4.9.3. Service Benchmarking
    • 6.4.9.4. Strategic Initiatives
  • 6.4.10. ExlService Holdings, Inc.
    • 6.4.10.1. Overview
    • 6.4.10.2. Financial Performance
    • 6.4.10.3. Service Benchmarking
    • 6.4.10.4. Strategic Initiatives
  • 6.4.11. MRIoA
    • 6.4.11.1. Overview
    • 6.4.11.2. Financial Performance
    • 6.4.11.3. Service Benchmarking
    • 6.4.11.4. Strategic Initiatives
  • 6.4.12. S&C Technologies, Inc.
    • 6.4.12.1. Overview
    • 6.4.12.2. Financial Performance
    • 6.4.12.3. Service Benchmarking
    • 6.4.12.4. Strategic Initiatives
• 6.5. Company Profiles: In-House Providers
  • 6.5.1. Ultimate Health Plans
    • 6.5.1.1. Overview
    • 6.5.1.2. Financial Performance
    • 6.5.1.3. Service Benchmarking
    • 6.5.1.4. Strategic Initiatives
  • 6.5.2. Security Health Plan of Wisconsin, Inc.
    • 6.5.2.1. Overview
    • 6.5.2.2. Financial Performance
    • 6.5.2.3. Service Benchmarking
    • 6.5.2.4. Strategic Initiatives
  • 6.5.3. Blue Cross and Blue Shield Association
    • 6.5.3.1. Overview
    • 6.5.3.2. Financial Performance
    • 6.5.3.3. Service Benchmarking
  • 6.5.4. Providence
    • 6.5.4.1. Overview
    • 6.5.4.2. Financial Performance
    • 6.5.4.3. Service Benchmarking
  • 6.5.5. Simply Healthcare Plans, Inc.
    • 6.5.5.1. Overview
    • 6.5.5.2. Financial Performance
    • 6.5.5.3. Service Benchmarking
  • 6.5.6. Health Plan of San Mateo (HPSM)
    • 6.5.6.1. Overview
    • 6.5.6.2. Financial Performance
    • 6.5.6.3. Service Benchmarking
  • 6.5.7. PerformRx
    • 6.5.7.1. Overview
    • 6.5.7.2. Financial Performance
    • 6.5.7.3. Service Benchmarking
  • 6.5.8. Aetna, Inc. (CVS Health Corp.)
    • 6.5.8.1. Overview
    • 6.5.8.2. Financial Performance
    • 6.5.8.3. Service Benchmarking
    • 6.5.8.4. Strategic Initiatives

List of Tables

• Table 1 List of secondary sources
• Table 2 List of abbreviations
• Table 3 Specialty drug expenditures, 2016 - 2021
• Table 4 U.S. drug utilization management market revenue estimates and forecast, by program type, 2021 - 2033 (USD Billion)
• Table 5 U.S. drug utilization management market revenue estimates and forecast, by end use, 2021 - 2033 (USD Billion)

List of Figures

• Fig. 1 U.S. drug utilization management market segmentation
• Fig. 2 U.S. drug utilization management market segmentation
• Fig. 3 Market research process
• Fig. 4 Data triangulation techniques
• Fig. 5 Primary research pattern
• Fig. 6 Market research approaches
• Fig. 7 Value chain-based sizing & forecasting
• Fig. 8 Market formulation & validation
• Fig. 9 Market snapshot
• Fig. 10 Segment snapshot
• Fig. 11 Competitive landscape
• Fig. 12 U.S. drug utilization management market: Ancillary/related market outlook
• Fig. 13 U.S. drug utilization management market dynamics
• Fig. 14 Market driver relevance analysis (Current & future impact)
• Fig. 15 Market restraint relevance analysis (Current & future impact)
• Fig. 16 U.S. drug utilization management market: Porter's five forces analysis
• Fig. 17 U.S. drug utilization management market: PESTLE analysis
• Fig. 18 U.S. drug utilization management market: Program type segment dashboard
• Fig. 19 U.S. drug utilization management market: Program type market share analysis, 2024 & 2033
• Fig. 20 In-house market, 2021 - 2033 (USD Billion)
• Fig. 21 Outsourced market, 2021 - 2033 (USD Billion
• Fig. 22 U.S. drug utilization management market: End use segment dashboard
• Fig. 23 U.S. drug utilization management market: End use market share analysis, 2024 & 2033
• Fig. 24 Health plan provider/Payors market, 2021 - 2033 (USD Billion)
• Fig. 25 Pharmacies market, 2021 - 2033 (USD Billion)
• Fig. 26 PBMs market, 2021 - 2033 (USD Billion)
• Fig. 27 Company categorization: Third-party providers
• Fig. 28 Company market position analysis: Third-party providers
• Fig. 29 Strategic framework: Third-party providers
• Fig. 30 Company categorization: In-house providers
• Fig. 31 Company market position analysis: In-house providers