During their first-quarter earnings calls in recent weeks, top executives at the companies that own the three largest PBMs in the U.S. discussed the regulatory challenges and inquiries facing the industry. They also defended the PBMs’ business practices, claiming they play a major role in negotiating drug prices on behalf of their clients. And they noted they have retained nearly all of their customers and added new ones despite the increased industry scrutiny.
Elected officials have targeted CVS Health Corp.-owned Caremark, The Cigna Group’s Express Scripts and UnitedHealth Group’s Optum Rx, accusing them of contributing to the high price of medications and for their lack of transparency. Those three PBMs have about an 80% market share, a consolidation of power that has garnered criticism from state and federal policymakers.