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The three largest—Caremark, Express Scripts, and OptumRx—which process roughly 80% of U.S. drug claims and are known as the Big Three, took in more than $430 billion in revenue in 2023.
The specialty pharmacy business had $20 billion in sales in 2005. By 2014 it had grown to "$78 billion in sales". [5] In Canada by 2013 "specialty drugs made up less than 1.3 percent of all Canadian prescriptions, but accounted for 24 percent of Canada's total spending on prescription drugs". [52]
In August 2008, CVS Caremark purchased Longs Drugs Stores for $2.7 billion. [ 12 ] In 2009, CVS Caremark agreed to pay $2.25 million to settle alleged unfair trade practices and alleged violations of the privacy protections under the Health Insurance Portability and Accountability Act of 1996 . [ 13 ]
By 2014 CVS Caremark, Express Scripts and Walgreens represented more than 50% of the specialty drug market in the United States. [19]: 4 other specialty providers included Commcare Pharmacy. By 2015 the trend among U.S. pharmacies is to "incorporate specialty pharmacy in their operations."
Pharmacy benefit managers, which serve as the middlemen between drug makers, insurers and pharmacies, reaped $7.3 billion in revenue from marking up the prices of dozens of specialty generic drugs ...
Other studies show a correlation between increases in a drug's list price and rising rebates for the drug. ... CVS Caremark with 33%, Express Scripts at 24%, and OptumRx owns 22% of the market ...
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