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Publication Details
- Pub Code: GDRU9-11WEB
- Pages: 188
- ISBN: 978-1-936230-17-4
- Copyright 2011
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2000-2011 Survey Results: Pharmacy Benefit Trends and Data
Valuable book and CD resource that features the complete results — plus analyses — of AIS’s quarterly survey of pharmacy benefit management companies. Coverage runs from the 1st quarter of 2000 through the 2nd quarter of 2011. Contains hundreds of charts, tables and graphs on costs, benefit design, utilization and PBM market share … in addition to a detailed directory of PBMs, PBAs, SPPs and related companies. An accompanying CD contains all of the raw survey data in spreadsheet form.
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
- Cost trends
- Mail order market share
- And much more.
This edition of Pharmacy Benefit Trends and Data captures membership and market share data from Q1-2000 until Q2-2011. That’s 46 surveys over 12 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 by brand and generic.
- Determine the point at which the copay differential (the price difference between one tier and the next) actively influences consumer behavior.
- Identify the most widely utilized prescription products at each PBM.
- Analyze utilization volume by benefit tier.
- Develop projections about the effect of changes 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.
- Track generic utilization rates per PBM and nationally.
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 number of clients and total Rx per year.
Table of Contents — Print Version
Chapter 1: PBM Drug Spend by Therapeutic Category
- 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
- Allergy/Rhinitis Drugs
- Asthma
- Cholesterol
- Diabetes
- Hypertension
- Migraine
- NSAIDs/Cox-2 Inhibitors
- Psychiatric/CNS drugs
- Ulcer/GERD
- Antibiotics
- Hormone Replacement Therapy (HRT)
Chapter 2: Prescription Drug Costs per Prescription, by Cost Component, Brand and Generic
- Ingredient Costs
- Dispensing Fees
- Actual Amount Paid per Rx
- Comparisons and Analysis
Chapter 3: Benefit Design Trends
- Copay Amounts
Chapter 4: Prescription Drug Utilization by Tier
- Total/Average Claims Processed by Tier
- Claims per Tier for Leading PBMs and PBAs
- Generic Fill Rate
Chapter 5: PBM Membership and Market Share
Chapter 6: PBM Prescription Volume and Mail-Order Growth
- Total Claims Processed by PBMs
- Prescription Volume by Sales Outlet — Retail, Mail, Specialty
- Retail Rx Utilization
- Mail Order Rx Utilization
Chapter 7: Evaluating Market Share by Different Business Volume Metrics
- Market Share by Covered Lives/Membership
- Market Share by Prescription Volume
- Mail-Order Market Share
- Market Share by Annual Drug Spend
Chapter 8: PBM Drug Spend
Chapter 9: Results of AIS’s Quarterly Survey of PBMs, PBAs, SPPs and Related Companies, Raw Survey Data per Company
Chapter 10: Evolution of the PBM Industry and Growth of Specific Companies
- Growth and Market Share of the Biggest PBM Consolidators
Chapter 11: Directory of PBMs, PBAs, SPPs and Related Companies
Contents — Accompanying CD Version
Chapter 1: PBM Drug Spend by Therapeutic Category (18 spreadsheets)
- Costs per Therapeutic Category as Percentage of Total Drug Costs
- Average by Quarter
- Minimum and Maximum Reported by Quarter
- Year-Over-Year Comparisons
- Trends
- Percentage Change
- Estimated Total Amount Spent by PBMs – 2002-2011 by Quarter
- Estimated Total Amount Spent by PBMs – 2006-2011 by Year
- Percentage of Total Drug Spend and Estimated Annual PBM Expenditures
- Allergy/Rhinitis
- Asthma
- Cholesterol/Statin
- Diabetes
- Hypertension
- Migraine
- NSAIDs/Cox-2 Inhibitors
- Psychiatric/CNS drugs
- Ulcer/GERD
- Antibiotics
- Hormone Replacement Therapy (HRT)
Chapter 2: Prescription Drug Costs per Prescription, by Cost Component, Brand and Generic (5 spreadsheets)
- By Cost Component – Rx Ingredient, Amount Paid, Dispensing Fee, Discount
- Average Costs by Quarter, 2000-2011
- Percentage Change, Year-Over-Year
- Trends – Generic vs. Brand, by Quarter
- Minimum and Maximum Reported by Quarter
- Specialty Pharmacy by Quarter
Chapter 3: Benefit Design Trends (6 spreadsheets)
- Copay Average – Three-Tiered Plans by Quarter
- Copay Trends by Tier
- Copay Range by Tier, by Quarter
- Percentage Change
- Average Copay per Tier per Company
- Covered Lives Under Formulary Control by Company – 2Q 2011
Chapter 4: Prescription Drug Utilization by Tier (7 spreadsheets)
- Average Utilization by Tier, by Quarter
- Utilization by Tier, by Company, by Quarter
- Percentage Utilization by Tier, by Company, 2Q 2002 - 2011
- Utilization by Tier, Number of Scripts per Company
- Estimated Scripts – individual spreadsheets for 2Q2002, 2Q2007, 2Q2011
- Generic Fill Rate per Company, 2Q 2010-2011
Chapter 5: PBM Membership and Market Share (14 spreadsheets)
- Total Lives by Quarter
- Lives per Company, 4Q 2000-2010
- PBM Market Share by Number of Covered Lives, by Company, individual spreadsheets for 2000-2011
Chapter 6: PBM Prescription Volume and Mail-Order Market Share (28 spreadsheets)
- Total Rx Volume by Quarter
- Total Rx Volume by Company, 4Q 2000-2010
- PBM Market Share by Total Annual Rx Volume, individual spreadsheets for 2000-2011 (2Q only)
- Rx Volume by Sales Outlet (Retail, Independent, Chain, Mail Order-Unadjusted, Mail Order-Adjusted, Specialty), by Quarter
- Rx Volume by Sales Outlet (Retail, Mail, Specialty), by Quarter
- Rx Volume by Quarter, Retail (Total) – Percentage Growth
- Rx Volume by Quarter, Retail (By Sales Outlet) – Percentage Growth
- Rx Volume by Quarter, Mail Order
- Mail order Rx Volume by Company, individual spreadsheets for 2004-2011 (2Q only)
- Mail Order Penetration by Company 2Q 2004-2011
Chapter 7: Evaluating Market Share by Different Business Volume Metrics (6 spreadsheets)
- Covered Lives, by Company – 2Q 2000-2011
- Covered Lives – Graphs by Company
- Prescription Volume – 2Q 2000-2011
- Prescription Volume – Graphs by Company
- Total Annual Drug Spend – 2Q 2005-2011
- Covered Lives, by Type of Ownership
Chapter 8: PBM Drug Spend Data (12 spreadsheets)
- Annual Drug Spend by Quarter, 2002-2010
- Annual Drug Spend,, individual spreadsheets for 2001-2011 (2Q only)
Chapter 9: Results of AIS’s Quarterly Survey of PBMs, PBAs, SPPs and Related Companies, Raw Survey Data per Company – 2000-2011, by quarter (46 spreadsheets – see data fields below)
Chapter 10: Evolution of the PBM Industry and Growth of Specific Companies (9 spreadsheets)
- Growth by Number of Covered Lives, 2006-2011
- Growth by Rx Volume, 2006-2011
- Timeline of Company M&A Activity, 2000-2011
- Catalyst Rx
- CVS Caremark
- Express Scripts
- Medco
- SXC
- Walgreens
- Covered Lives & Market Share, Rx Volume and Market Share, 1998
Chapter 11: Directory of PBMs, PBAs, SPPs and Related Companies
- Includes 104 companies and 550 executives
- Data fields include:
- Company name, address, phone, fax, URL
- Executive first name, last name, title
Data Fields in AIS’s Exclusive Quarterly Surveys
- Company Name
- Drug Spend per Year
- % 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
- 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
- Generic Fill Rate
- Annual Rx Under Medicare Part D
- Annual Rx Under Medicaid
- Annual Rx Under Commercial Plans
- Company Services
- PBM
- PBA
- Fiscal Intermediary
- Claims processor
- Specialty Pharmacy
- Specialty Infusion Provider
- Mail Order Rx
- Benefit Consultant
- Discount Card Vendor
- Oncology Management
- Disease Management
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
AIS Guarantee
Order Pharmacy Benefit Trends and Data for a 30-day risk-free inspection and test for yourself the value of this highly practical resource. If within 30 days you're not interested in keeping it, just return it to AIS and we will send you a prompt, full refund or credit. For CD purchasers, refunds will not be made once the seal on the CD package has been broken. Please review your copy of the print version prior to breaking the seal.
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2000-2011 Survey Results: Pharmacy Benefit Trends and Data
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