S5, Ep 7- The Big Three: Unraveling the Oligopoly of Pharmacy Benefit Managers

In this episode of Healthcare Matters, join Dr. Robert Popovian and Ben Blanc as they dissect the critical role of Pharmacy Benefit Managers (PBMs) in the health care system, guided by recent findings from the Federal Trade Commission (FTC). The episode delves into how PBMs control a significant portion of the U.S. prescription market, discussing the implications of their dominance on drug prices, and the viability of independent pharmacies. Featuring a thorough examination of the FTC's recent report, Dr. Popovian explores the deep-seated issues of market concentration, anti-competitive practices, and the need for substantial regulatory reform.

This episode aims to shed the light on the powerful influence PBMs have over drug access and affordability, proposing pathways for more equitable health care practices.

Among the highlights in this episode:

01:45: Dr. Popovian delves into the FTC's report, revealing that three major PBMs control 80% of the retail prescription market in the U.S., highlighting issues of market concentration and limited competition

02:46: The conversation shifts to the impact of PBMs on drug prices and pharmacy operations, focusing on the FTC's concerns over anti-competitive practices 

03:14: Dr. Popovian explains the effects of vertical and horizontal integration among PBMs, affecting drug access and pricing

06:35: Our hosts discuss the struggles faced by independent pharmacies due to PBM practices, as revealed in the FTC report

09:59: Dr. Popovian explores how PBMs use formulary design to manipulate which drugs patients can access and at what cost

11:59: Dr. Popovian criticizes the current rebate practices by PBMs, discussing their detrimental effects on the availability of generic and biosimilar drugs

14:25: Dr. Popovian calls for greater transparency and potential regulatory reforms to ensure fair drug pricing and maintain pharmacy viability

16:44: Dr. Popovian shares some final thoughts

To read the full FTC report “Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies,” go to: https://www.ftc.gov/reports/pharmacy-benefit-managers-report

Contact Our Hosts

Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [e-mail]

Ben Blanc, Associate Director, Digital Production and Engagement at GHLF: [e-mail]

A podcast series produced by Ben Blanc.

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