According to the report, between 2017 and 2019:

PBM gross profits increased by 12%, from $25 billion to $28 billion.
Gross profits from PBM-owned mail-order and specialty pharmacies increased by more than 13%, from $8.9 billion to $10.1 billion.
Gross profits from other sources, including spread pricing, pharmacy fees and clawbacks, fees collected from payers and other non-administrative fees collected from manufacturers grew by nearly 26%, from $8.5 billion to $10.7 billion.

The report discusses the market dynamics and misaligned incentives that the organization believes have resulted in systemwide inefficiencies and allowed PBMs to drive up costs for patients, employers and the overall health care system. PBMs benefit directly from prescription medicine list price growth, leading to misaligned incentives in the system. Several sources of PBM revenue for medicines are linked directly to the list price of the medicine. When the list price of a medicine goes up, the PBM often collects more revenue. These misaligned incentives can drive up costs for plans and patients.

Instant Insights /

PBMs are profiting at expense of consumers and other stakeholders, group alleges

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