Pharmacy Benefit Managers Under Fire for Inflating Drug Costs
FTC report and independent pharmacies highlight the growing influence and controversial practices of PBMs in the U.S. healthcare system.
Overview
- Pharmacy benefit managers (PBMs) are accused of profiting by inflating drug costs and disadvantaging independent pharmacies.
- The three largest PBMs—CVS Caremark, Cigna's Express Scripts, and UnitedHealth's Optum RX—control 80% of U.S. prescriptions.
- Independent pharmacies report financial struggles due to low reimbursement rates from PBMs, threatening their survival.
- State legislatures and the FTC are investigating PBM practices, with some states attempting to pass regulatory laws.
- PBMs argue that they lower drug costs, but critics claim their practices harm patients and small pharmacies.