Company Directory - Pharmacy Benefit Managers
Company Details - Pharmacy Benefit Managers
Pharmacy Benefit Managers
Pharmacy Benefit Managers (PBMs) are third‐party administrators that manage prescription drug benefits for employers, health insurers, and other payers. They negotiate with drug manufacturers and pharmacies, manage formularies, and process claims. Despite playing a key role in controlling drug spending, PBMs have faced criticism for allegedly not securing the best deals and for practices that may disadvantage independent pharmacies.
CCI Score
CCI Score: Pharmacy Benefit Managers
-50.62
0.02%
Latest Event
Criticism of PBMs' Disadvantaging Practices
Mark Cuban's initiative to bypass Pharmacy Benefit Managers (PBMs) has brought to light longstanding criticisms that PBMs compromise optimal drug deals and contribute to independent pharmacies struggling to survive, thereby fostering pharmacy deserts.
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QUISLING
Pharmacy Benefit Managers is currently rated as a Quisling.
Latest Events
- MAR282025
Mark Cuban's initiative to bypass Pharmacy Benefit Managers (PBMs) has brought to light longstanding criticisms that PBMs compromise optimal drug deals and contribute to independent pharmacies struggling to survive, thereby fostering pharmacy deserts.
- MAR142025
A bipartisan effort to reform pharmacy benefit manager practices—including measures aimed at curbing spread pricing, opaque rebates, and conflicts of interest—was scuttled amid political pressure reportedly exerted by former President-elect Donald Trump and Elon Musk. This rollback preserves industry practices that have long harmed patients by incentivizing profit over transparency and equitable drug pricing.
-20
Public and Political Behavior
March 28
The failure to pass PBM reforms, influenced by external political pressure from authoritarian figures, indirectly benefits PBMs by preserving a system that undermines democratic accountability. This reflects a negative impact in the realm of public and political behavior.
Pharmacy Benefit Manager Reform Scuttled, Despite Bipartisan Support
-50
Business Practices and Ethical Responsibility
March 28
PBMs have long been criticized for manipulative business practices including spread pricing, lack of rebate transparency, and conflicts of interest that disadvantage patients and independent pharmacies. The abandonment of reform efforts reinforces these unethical practices.
Pharmacy Benefit Manager Reform Scuttled, Despite Bipartisan Support
-25
Economic and Structural Influence
March 28
The PBM industry’s structural influence in the pharmaceutical supply chain, combined with its vertical integration and market power, reinforces an environment where reforms are continually blocked, thereby entrenching economic disparities and limiting patient access to cost-effective drugs.
Pharmacy Benefit Manager Reform Scuttled, Despite Bipartisan Support
- JAN242025
On January 24, 2025, bipartisan lawmakers introduced the Patients Before Monopolies Act aimed at curbing opaque and monopolistic practices among pharmacy benefit managers. The proposed legislation seeks to force companies that own both PBMs and pharmacies to divest the pharmacy operations, addressing concerns over alleged price-fixing, vertical integration, and economic harm to independent pharmacies.
-40
Public and Political Behavior
March 28
Lawmakers from both parties have criticized PBMs for conducting secretive practices that undermine public trust. The call for transparency and accountability reflects a negative assessment of PBMs' influence on public policy and their reluctance to align with community interests.
In the Crosshairs: Officials push for transparency, accountability among pharmacy benefit managers
-25
Business Practices and Ethical Responsibility
March 28
The article highlights unethical business practices including alleged price-fixing and vertical integration that hurt independent pharmacies. Such practices reflect a disregard for ethical business standards and a prioritization of profit over patient care.
In the Crosshairs: Officials push for transparency, accountability among pharmacy benefit managers
-30
Economic and Structural Influence
March 28
PBMs are acting as gatekeepers with significant economic power, consolidating market share and contributing to monopolistic structures in the healthcare system. Their market dominance stifles competition and adversely affects smaller, independent pharmacies as well as patients.
In the Crosshairs: Officials push for transparency, accountability among pharmacy benefit managers
- JAN152025
The FTC released a report on January 15, 2025, alleging that major pharmacy benefit managers generated $7.3 billion by marking up drug prices excessively. The report details practices such as spread pricing and diverting prescriptions to affiliated pharmacies, practices which harm independent pharmacies and burden patients with higher costs.
-75
Business Practices and Ethical Responsibility
March 28
The FTC report documents unethical business practices by PBMs including excessive drug markups, spread pricing, and diverting prescriptions away from independent pharmacies. These actions undermine fair market competition and harm vulnerable patients, reflecting a significant breach of ethical responsibility.
-60
Economic and Structural Influence
March 28
The report underscores the structural and economic dominance of PBMs in the pharmaceutical market, highlighting monopolistic and anti-competitive practices. These practices enable them to generate enormous profits at the expense of consumer affordability and market fairness.
- JAN142025
On January 14, 2025, the FTC released its second report alleging that major Pharmacy Benefit Managers engaged in practices that inflated drug costs by steering prescriptions to affiliated pharmacies and employing controversial pricing strategies, harming independent pharmacies and raising consumer costs.
-70
Business Practices and Ethical Responsibility
March 28
The FTC report highlights unethical business practices by PBMs, including excessive markups on specialty generics, spread pricing, and preferential treatment of their own pharmacies. These practices not only inflate drug costs but also disadvantage independent pharmacies, reflecting serious ethical and consumer harm issues.
FTC releases second report slamming pharmacy benefit managers
-50
Economic and Structural Influence
March 28
The report reveals that PBMs leverage their market power to manipulate drug pricing through structural practices that generate billions in additional revenue, thereby undermining fair competition and hurt independent pharmacies.
FTC releases second report slamming pharmacy benefit managers
- SEP202024
On September 20, 2024, the FTC filed a lawsuit against major pharmacy benefit managers, alleging that they manipulated drug pricing—particularly for insulin—by using their negotiating power to incentivize manufacturers to raise list prices, ultimately shifting costs onto vulnerable patients. This legal action highlights concerns over unethical business practices and structural economic influence within the industry.
-70
Business Practices and Ethical Responsibility
March 28
Pharmacy Benefit Managers are accused of engaging in unethical business practices by manipulating rebate systems and negotiating in a way that encourages drug manufacturers to inflate prices, particularly for life-saving medications like insulin. This action exacerbates healthcare inequities and places a disproportionate financial burden on vulnerable populations.
FTC takes legal action against pharmacy benefit managers, citing a distorted drug-pricing structure
-50
Economic and Structural Influence
March 28
The lawsuit underlines structural economic issues where PBMs leverage their market position and vertical integrations to distort drug pricing. These practices contribute to an economic environment that shifts costs onto patients and undermines fair market dynamics.
FTC takes legal action against pharmacy benefit managers, citing a distorted drug-pricing structure
- OCT242023
Legislators and regulators are scrutinizing Pharmacy Benefit Managers over market dominance, conflicts of interest, and practices that may disadvantage patients, spurring legislative and FTC actions as detailed in the article.
-60
Business Practices and Ethical Responsibility
March 28
The article highlights that PBMs engage in practices such as prioritizing their profits through aggressive discount negotiations and rebate strategies that ultimately increase patient costs. These practices point to unethical business methods that harm public welfare.
-50
Economic and Structural Influence
March 28
The vertical integration and market dominance of PBMs, as discussed in the article, create structural imbalances in the healthcare sector. This excessive economic influence undermines fair competition and contributes to policies that may harm marginalized communities.
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Industries
- 524114
- Direct Health and Medical Insurance Carriers
- 524292
- Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
- 541611
- Administrative Management and General Management Consulting Services