The Federal Trade Commission (FTC) recently published a report titled “Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies.” The report contains compelling statistics and visuals on pharmacy benefit managers (PBMs). Here are some key points:
PBMs now have a more comprehensive role beyond formulary design and are often directly owned by health plans.
Over the past 25 years, PBMs have grown significantly due to consolidations.
The market dominance of the top three PBMs – CVS Caremark, Express Scripts (ESI), and OptumRx – has increased from 70% to 79%.
Specialty mail order pharmacy is gaining importance in PBM revenue compared to other distribution channels.
As of 2023, revenue from PBM parent companies accounted for 22% of all US national health expenditures.
For more details, refer to the full report here.
