Doctor and business man holding up medication concepts The largest PBMs have the advantage of size and negotiating power, and access to an extensive portfolio of specialty, brand, and generic medications. (Photo: Shutterstock)

Two new pharmacy benefit managers (PBMs) are looking to disrupt the industry: Mark Cuban’s Cost Plus Drug Company and the Purchaser Business Group on Health (PBGH), a nonprofit coalition. Both companies are looking to promote drug pricing transparency, which larger PBMs like CVS and United HealthCare have been reluctant to do. Converse views and legislative efforts around drug pricing have continued to elevate over the past few decades.

In November 2021, Congress actively debated the Build Back Better Act, which included the potential to allow Medicare negotiating power over drug pricing in a limited set of products. The advent of vertical integration by larger PBMs, the balance between innovation and cost in pharmaceutical development, and the political pressure to reduce drug spending will be factors into the success of these two companies.

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