Final week, the Federal Commerce Fee (FTC) launched a report titled “Pharmacy Profit Managers: The Highly effective Middlemen Inflating Drug Prices and Squeezing Principal Road Pharmacies.” Whereas I gained’t get into an evaluation of the precise arguments FTC made, the report does have quite a lot of fascinating statistics and graphics on pharmacy profit managers (PBMs). Some highlights are beneath.
First, PBMs do far more than simply design formularies. Now they’re extremely built-in entities, with many massive PBMs being owned straight by well being plans.
PBM dimension elevated resulting from a sequence of consolidations over the previous 25 years.
The market share of the three largest PBMs (CVS Caremark, Specific Scripts (ESI), and OptumRx) elevated from 70% to 79% of the PBM market.
Specialty mail order pharmacy is rising as a share or PBM income relative to different channels.
Actually, PBM dad or mum corporations’ income comprised 22% of all US nationwide well being expenditure as of 2023.
You possibly can learn the total report right here.