May 30, 2019

The market power of PBMs

Reproduced from Adam Fein of the Drug Channels Institute; Chart: Axios Visuals
Reproduced from Adam Fein of the Drug Channels Institute; Chart: Axios Visuals

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.

Go deeper: The data showing drug pricing games

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