Investor Presentation: First Nine Months of 2020
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Investor presentation First nine months of 2020
US health insurance is dominated by few large commercial
payers with slow expansion of public insurance coverage
The US population by health insurance status expected to remain
stable in coming years
Managed Care
Medicaid
Public exchanges
Medicare
Uninsured
Other
326
333
100%
9%
8%
80%
23%
22%
60%
18%
18%
40%
20%
45%
44%
In 2018, PBMs covered 288 million lives and the market has
consolidated
MedImpact
All other PBMS
Humana
5%
3%
Prime
3%
8%
OptumRx
22%
31%
CVS
Caremark
0%
2017
2020
28%
Express
Scripts
12017 data reflect historical data through Oct 2017
2 Managed care population is slightly underestimated as only population under the age 65 is captured to avoid double
counting with those eligible for Medicare.
Source: Census.gov; Congressional Budget Office Health Insurance Coverage 2016-2026; Medicare Enrollment
Dashboard; CMS Health Insurance Enrollment Projection 2015-2025; Medicaid and CHIP Enrollment Report Oct 2017;
CMS Insurance Marketplace Fact sheet 2017; CDC.gov
PBM: Pharmacy Benefit Manager
Note: Covers all main channels (Managed Care, Medicare Part D, and Medicaid); market share based on claim
adjudication coverage, i.e. not on formulary/rebate decision power
Sources: Cleveland Research
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