Express Scripts Expands Lead as CVS Caremark Sees Second Year of Declining Claim Volume in 2025 PBM Market Analysis

The latest analysis of the pharmacy benefit manager (PBM) market for 2025 reveals that three major companies—CVS Caremark, Express Scripts, and Optum Rx—continue to dominate the industry, collectively handling 80% of all equivalent prescription claims. Among these, Express Scripts has widened its lead over competitors, while CVS Caremark experienced a decline in claim volume for the second consecutive year. Despite this concentration at the top, smaller independent PBMs are gradually gaining ground, though many still depend on larger players for essential services such as claims processing and rebate negotiations.

The findings also highlight significant shifts within the PBM landscape driven by regulatory changes and evolving client demands. The “Big Three” PBMs are restructuring their operations in response to increased scrutiny and competitive pressures. Emerging trends such as the Net Pricing Drug Channel are expected to further reshape how these companies generate revenue, negotiate contracts, and position themselves within the broader pharmaceutical supply chain. These developments underscore ongoing fragmentation at the margins of the market while maintaining a high level of consolidation among leading firms.

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Date: March 30, 2026

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GOAI