Americans have long been frustrated with the high costs of prescription drugs, pointing fingers at drug companies, insurers, and the government. However, there is a lesser-known group that plays a significant role in inflating drug prices – pharmacy benefit managers (P.B.M.s).
These P.B.M.s, owned by major health care conglomerates like CVS Health, Cigna, and UnitedHealth Group, act as middlemen for over 200 million Americans. While their primary role is to reduce drug costs, they often do the opposite. They push patients towards more expensive medications, add hefty markups to cheap drugs, and collect billions of dollars in hidden fees.
Most Americans receive their health insurance through either a government program like Medicare or their employer. These insurances cover two main aspects – visits to doctors and hospitals, and prescription drugs. The latter is where P.B.M.s step in to manage and oversee the costs.
The opaque nature of P.B.M.s allows them to operate in secrecy and complexity, making it difficult for the average person to understand their impact on drug prices. While drug companies and insurers are often in the spotlight for high costs, P.B.M.s play a crucial role behind the scenes.
It is crucial for consumers, employers, and the government to understand how P.B.M.s contribute to the rising costs of prescription drugs. By shedding light on this hidden aspect of the pharmaceutical industry, we can work towards creating a more transparent and affordable healthcare system for all.