Call for action
Thirty-nine state attorneys general called on Congress to pass legislation to prohibit pharmacy benefit managers from owning or operating pharmacies.

Pharmacy middlemen
PBMs negotiate prices between manufacturers and pharmacies while also managing prescription drug benefits and formularies.

Years of consolidation
The big three pharmacy benefit managers all have their own online or brick-and-mortar pharmacies and insurance providers.

The top three pharmacy benefit managers processed nearly 80% of the roughly 6.6 billion prescriptions filled by pharmacies in 2023, according to the FTC.

In April, Arkansas Gov. Sarah Huckabee Sanders, R, signed legislation banning PBMs from owning pharmacies in the state, claiming that the companies engage in anticompetitive practices. Meanwhile, a handful of other states have laws in the works to address the payment processors. On top of potential legislation, 39 state attorneys general called on Congress to pass legislation similar to Arkansas’ on the federal level.

Health care
The top three pharmacy benefit managers processed nearly 80% of the roughly 6.6 billion prescriptions filled by pharmacies in 2023, according to the FTC.