In a Kansas City Star guest commentary (6/25/25 page 14A), Jamie Corley, executive director of the nonprofit Prescription ...

PBMs argue that as middlemen between large pharmaceutical companies and consumers, they save patients money. Middlemen contend that critics have cherry-picked cases while “completely ...

A Different Model. But these alternative PBMs operate in a different way -- they charge a flat per-member-per-month fee to employers and then pass along 100% of rebates to them, which they contend ...

PBMs steering patients to their own pharmacies is also threatening the health of independent pharmacies, testified Hugh Chancy, president of the National Community Pharmacists Association.

The U.S. Supreme Court declined to review an appeals court ruling that struck down key parts of an Oklahoma law regulating ...

T he three largest pharmacy benefit managers (PBMs) inflated the price of specialty generic drugs beyond their costs of acquisition, earning more than $7.3 billion in revenue from 2017 to 2022 ...

The six largest PBMs — CVS Caremark, Express Scripts, Optum Rx, Humana Pharmacy Solutions, MedImpact and Prime Therapeutics — manage nearly 95% of all prescriptions filled in the U.S.

PBMs use their new power over market access and price to extract hundreds of billions of dollars from the market through tactics under investigation by regulators and which, according to my ...

PBMs counter by arguing that they save payers (and, by extension, patients) money by increasing buyer power in negotiations with pharma companies. The Pharmaceutical Care Management Association argues ...

The PBMs do not reimburse pharmacies for these transactions, meaning the patients' cash payment represents the pharmacies' only revenue, and PBMs' profits increase, the lawsuits say.

PBMs also faced questions on group purchasing organizations, or groups that leverage purchasing power to negotiate drug prices. From 2019 to 2021, the big three PBMs established locations overseas.

PBMs typically negotiate concessions below the nominal list prices of prescription drugs. The PCMA is challenging a provision of the rule set to take effect in January that would require them to ...