The Opaque Industry Inflating Prices for Prescription Drugs

Pharmacy Benefit Managers (PBMs) are under scrutiny for driving up prescription drug costs in the United States. These middlemen, including CVS Health, Cigna, and UnitedHealth Group, oversee prescriptions for over 200 million Americans. Despite their role in reducing drug costs, they often do the opposite by steering patients towards pricier drugs, charging high markups, and extracting hidden fees. The largest PBMs have been found to prioritize their financial interests over clients and patients, pushing for higher out-of-pocket costs, overcharging for drugs, and delaying prescriptions. Their opaque practices impact all Americans, leading to inflated drug costs and limited healthcare access. Recent mergers have consolidated their power, with the top three PBMs processing around 80% of prescriptions in the country. While PBMs claim to offer overall lower prices, critics argue that their actions contribute to the high cost of prescription drugs. Lawmakers and regulators are increasingly scrutinizing PBMs for potentially inflating prices and engaging in anticompetitive behavior, highlighting the complex and controversial role these entities play in the healthcare system.