Why We Need An Investigation Into The Secretive Practices Of Pharmacy Benefit Managers

A consolidation in drug providers over the years has led to 77% of all prescriptions filled nationwide being controlled by three Pharmacy Benefit Managers (PBMs). These pharmaceutical industry giants act as corporate middlemen, keeping a cut of the profits on drugs for themselves and creating higher prices across the country. And all owned by the largest health insurers: Caremark (owned by CVS), OptumRx (owned by United Health), and Express Scripts (owned by Cigna, as reported by Becker’s Hospital Review.

The top PBMs are owned by the largest health insurers: Caremark (owned by CVS), OptumRx (owned by United Health), and Express Scripts (owned by Cigna)
The top PBMs are owned by the largest health insurers: Caremark (owned by CVS), OptumRx (owned by United Health), and Express Scripts (owned by Cigna).

Defenders of Big Pharma would tell you Pharmacy Benefit Managers (PBMs) aim to lower drug costs and help patients efficiently access medications. In reality, PBMs spike the prices of life-saving drugs like insulin, steal from community pharmacies until they go bankrupt, and turn pharmacy care, an important (and often only) source of health care for rural patients, into a living nightmare, according to the LA Times.

77% of all prescriptions filled nationwide being controlled by three PBMs.
77% of all prescriptions filled nationwide being controlled by three PBMs.

PBMs decide what pharmacies you can use, which of your medications are covered by insurance, and how much you, the pharmacy, and your insurance company must pay, giving them immense control over drug prices in the United States, explains the Commonwealth Fund.

When FTC Chair Lina Khan first pushed to investigate PBMs’ role in sky-rocketing drug prices and illegal monopolistic practices in 2021. Commissioners Noah Phillips and Christine Wilson blocked the investigation, according to Dispatch.

PBMs decide what pharmacies you can use, which of your medications are covered by insurance, and how much you, the pharmacy, and your insurance company must pay.
PBMs decide what pharmacies you can use, which of your medications are covered by insurance, and how much you, the pharmacy, and your insurance company must pay.

Commissioners Phillips and Wilson voted against confirming the investigation because they claimed it was too broad in scope and lacked focus. With the knowledge that millions of Americans rely on the pharmacy system to survive, further supported by signatures from our readers, they may stand down the next time a vote is called.

Click below and sign the petition and help us ask FTC Commissioner Noah Phillips and Commissioner Christine Wilson to stop blocking efforts to open an investigation into PBMs.

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