The Federal Trade Commission recently launched an inquiry into the practices of pharmacy benefit managers, known in the industry as PBMs. PBMs are the hidden middlemen who were supposed to make drug distribution more efficient. Yet over time, they have grown in size and power, and research suggests they have contributed to the rapidly rising costs of prescription drugs, while taking home a growing chunk of those ballooning prices. The way that their growth and growing profits puts critical drugs out of reach for many, contributing to avoidable deaths and disease, may be extreme but it’s not an aberration. It is instead reflective of the way the growing size and power of middlemen is undermining the health of the economy and the real people the economy is supposed to help serve.