Alright, folks, buckle up, because this one’s gonna make your blood pressure so high, you’ll need a prescription—if you can afford one! Let’s talk about pharmacy benefit managers, or PBMs, which I think stands for “Profits Before Medicine.” These middlemen are marking up the cost of specialty drugs by 1,000%! One thousand percent! That’s not a markup; that’s robbery with a calculator!
Picture this: you’ve got cancer, and your doctor says, “Here’s a medication to save your life.” Then the PBM swoops in like, “Yeah, that’ll be $50,000 a month. Pay up or just, you know, die slower.” And we’re supposed to be okay with this? These people have the moral compass of a shark on cocaine.
The FTC just dropped a report exposing how these PBMs raked in an extra $7.3 billion—yes, billion with a “B”—over five years by marking up drug prices. Their favorite scam? “Spread pricing.” Sounds fancy, right? Like something on a charcuterie board. Nope! It’s where they charge insurance companies one price for your meds, reimburse pharmacies way less, and then pocket the difference. It’s like ordering a $20 martini and realizing they used the cheapest bottom-shelf vodka. Only in this case, it’s life-or-death, not happy hour!
And these PBMs own pharmacies too! Talk about rigging the system. They’re like that shady kid in Monopoly who hands out money but also owns all the hotels on Boardwalk and Park Place. They reimburse their own pharmacies more than independent ones because, hey, why not? Independent pharmacies? They’re out here struggling harder than your uncle at karaoke night. “Goodbye, small business!” they’re singing as PBMs shove them off the map.
But wait, there’s more! These PBMs have the audacity to say this is all for our benefit. Benefit, my ass! CVS is out here saying the FTC cherry-picked the data. Really? Cherry-picked? You mean like the way you cherry-pick your profits while Americans are forced to decide between buying medication or feeding their kids? Meanwhile, Optum Rx says, “Oh, but we saved consumers money!” Yeah, and I’m a size 2. Give me a break!
Let’s talk about the markups, shall we? The FTC found specialty drugs with price increases in the thousands of percent. One thousand percent! If a gallon of gas went up 1,000%, you’d be siphoning fuel out of your neighbor’s car faster than you can say “PBM.” But it’s healthcare, so we’re all supposed to just sit here and take it.
And the hits keep coming. These PBMs aren’t just killing your wallet—they’re killing competition. They’ve created “pharmacy deserts” where independent pharmacies can’t survive. So now, instead of driving five minutes to pick up your meds, you’re schlepping an hour to a big-box pharmacy, where you’ll pay a premium just for the privilege of not dying today.
You’d think Congress would be all over this, but these PBMs have so much cash in their pockets, they’ve got politicians doing backflips like circus seals. “Oh, don’t regulate us,” they cry. “We’re helping people!” Helping? Sure—helping themselves to everything but your spleen. And don’t give them ideas; they’ll start selling that too!
Here’s the bottom line: these PBMs need to be shut down faster than a toddler’s tantrum in church. The FTC report is proof they’re out of control, and it’s time for the government to step in and say, “Enough is enough.” Because right now, millions of Americans are getting fleeced, and the PBMs are laughing all the way to the bank. And if we don’t fix this mess? We’re all gonna need a new prescription—because this kind of greed is enough to give everyone a heart attack.
