Once about a time health insurance planned sponsors expanded their coverage to include prescription drugs. They turned to a new kind of company, a sort of middleman, to process those prescription claims for a small fee. Everyone was happy planned sponsors had someone else to administer all those claims. The claims processors made money providing the service, and patients had easy access to their medications at their neighborhood performuses. But as time passed, those middlemen began to exert more and more control over patients prescription drug benefits. It wasn't long before they had morphed from something good and useful into huge publicly traded companies with shareholders to satisfy. 

They even took a new name. Pharmacy Benefit Manager and the their Out Today PBS control the pharmacy benefits of more than 200 and 53 million Americans. After numerous acquisitions and consolidations, just three PBS now control 78 percent of prescription drug benefit transactions in the United States. Those PBS like to market themselves as the controller's cost in the supply chain. That's their story, but that's all. It is a story. Drug expenditures keep going up. We all seem to be paying more, not less. And those middlemen the PBS. Well, they've not only gotten powerful, they've also gotten rich, very, very rich. 

Pbs extract profits from new prescription claims in three ways, fees, rebates, and spread. Today's largest pms say they lower prescription drug benefit costs for planned sponsors. Yet since 1987, total spending on prescription drugs in the US has increased 1 thousand and ten percent. The US economy as a whole only grew about 100 and 26 percent in that same time period. The amount of money consumers themselves are paying for prescriptions has groaned 100 and 69 percent in that same time period. But despite the massive savings in generic drugs, despite enormous increases in manufacturer rebates, and despite increased plan costs to employers and consumers. PBM profits have increased exponentially. 

Those profits PBS extract from the prescription drug supply chain actually increase prescription drug costs, just the opposite of what PBS claim. 

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