May 30, 2019
The market power of PBMs
CVS Health, Express Scripts (now owned by Cigna) and OptumRx (owned by UnitedHealth Group) continue to control a vast majority of the drug insurance market, according to new estimates from Adam Fein of the Drug Channels Institute.
The bottom line: Those 3 pharmacy benefit managers handled more than 75% of all prescription claims in 2018.
The big picture: Employers usually don't switch drug benefits companies because they don't want to enrage their workers with the changes, which has given the big 3 players longstanding power in the market.
- However, Anthem is starting its own competing PBM, and lawmakers want to overhaul how these drug pricing middlemen operate.
Go deeper: The data showing drug pricing games