About PBMs

The PBM industry originally existed to help manage prescription drug costs and benefits overall. Today, PBMs are turning potential prescription drug savings into profits for themselves—the highest rates of profit across the entire prescription drug supply chain. Three major PBM companies have taken control of the market, and are listed on the Fortune 25 list. They are ranked higher than the drug manufacturers whose prices they had promised to control.

 

PBMs are now connected with several entities in the drug pricing marketplace. They are often vertically integrated with insurance companies, own or are affiliated with chain or specialty pharmacies, and have established affiliated group purchasing organizations (GPOs) - often located overseas - that operate in the shadows. 

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It’s no coincidence that PBM profits are increasing while out-of-pocket drug costs are rising, particularly for vulnerable patient populations. As PBMs are facing increased scrutiny among legislators and regulators, more and more data is coming to light. See below for more on the ways PBMs profit, their role in the drug pricing system, what experts are saying, and more.