The recent federal reforms to pharmacy benefit managers are a meaningful step in the right direction, but the work is not over yet, according to experts.
In January 2025, the Federal Trade Commission released a report that revealed pharmacy benefit managers (PBMs) overcharged for specialty generic medications — in many cases by hundreds and thousands of percent — for billions in profits. And, according to a report on U.S. Pharmacies and Pharmacy Benefit Managers, the three largest PBMs in the United States — Optum Rx (a subsidiary of UnitedHealth Group), Caremark Rx (a subsidiary of CVS Health