Here's how the six largest health insurance companies and their pharmacy benefit manager companies stack up.
1. UnitedHealth Group's PBM, Optum Rx, accounted for 22% of the 2022 PBM industry with managed claims. Two other PBMs outpaced Optum Rx in 2022: CVS Health/Caremark (33%) and Cigna/Evernorth/Express Scripts (24%). In 2023's third quarter, Optum Rx raked in $28.9 billion — and it led the growth of UnitedHealth Group's Optum segment, which swelled 22% since a year prior.
2. The PBM for Elevance Health (formerly Anthem) is Carelon Rx, which was formerly named Ingenio Rx. It was launched in late 2017 and began offering PBM services about two years later. In the third quarter of 2023, Carelon reported a total operating revenue of $11.9 billion in the third quarter, up 14% year over year. Operating gain was $650 million, a 1.4% annual increase.
3. Aetna's PBM is CVS Caremark. In the third quarter, revenues from the health services segment, which includes care delivery services, were $46.9 billion, up 8.4% from the previous year.
4. Cigna's PBM is Express Scripts, which lives under Evernorth Health Services. The division grew its revenue by 8% between the third quarters of 2022 and 2023, earning nearly $38.6 billion.
5. Beginning Jan. 1, the PBM for Centene's 28 million members will be Cigna's Evernorth/Express Scripts. The payer's previous PBM contract was with CVS Caremark, but in 2020, Centene signed a $200 million contract with Express Scripts.
6. Humana is reportedly in talks to merge with Cigna. Humana's PBM is named Humana Pharmacy Solutions, which made up 8% of prescription claims in 2022. In 2023's third quarter, the PBM reported $2.7 billion in revenue, amounting to $8.5 billion so far in 2023.