2020 Year in Review: PBMs Integrated, Expanded Offerings in ’20 Amid Uncertainty

In 2020, the PBM industry continued to deepen its integration with other industry players, a trend that experts say is likely to continue in coming years. Meanwhile, PBMs faced rising regulatory scrutiny and saw their mail-order business lines experience a boom in consumer demand amid the COVID-19 pandemic.

The PBM space has consolidated to the point that five firms — UnitedHealth Group’s OptumRx, CVS Health Corp.’s Caremark, Cigna Corp.’s Express Scripts, Anthem Inc.’s IngenioRx, Humana Inc.’s Humana Pharmacy Solutions, and the Blue Cross and Blue Shield affiliate-owned Prime Therapeutics LLC — manage the lion’s share of the pharmacy benefits offered to U.S. health plan members. Beyond their deepening integration with the payers that own them, these firms are working to expand their data and direct-to-consumer operations.

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• Radar on Drug Benefits