Becker's Healthcare November 13, 2024
What do you do when there’s an oligopoly controlling an industry, inhibiting price competition and consumer choice? You break it up. The three dominant pharmacy benefit managers (PBMs), CVS Caremark, Cigna’s Express Scripts and United’s OptumRx are drug-pricing middlemen, increasing costs and limiting choice for more than 200 million Americans. Collectively, they process more than 80% of prescriptions in the U.S., up from 50% in 2012. It’s time for their hold on employers and consumers to end.
PBMs were created by the pharmacy community to better connect the vast array of retail pharmacies to improve the patient experience, and to allow for near-instant electronic claims processing for prescriptions. They have since evolved, pushing employers and consumers to more expensive...