04/19/2025
Patients are being forced into PBM-owned mail-order and specialty pharmacies — not by choice, but by design.
💣 Behind the scenes, Pharmacy Benefit Managers (PBMs) are:
Requiring state employees and retirees to use PBM-owned mail-order pharmacies.
Steering high-cost medications — like cancer and MS drugs — to their own retail, mail, and specialty arms.
Stripping local pharmacies out of networks that serve Medicaid, retirees, and public employees.
🔎 According to the FTC:
The Big 3 PBMs (CVS Caremark, Express Scripts, OptumRx) control nearly 80% of all U.S. prescriptions
Their affiliated pharmacies receive 70% of specialty drug revenue, up from 54% in 2016
When prescriptions are profitable, PBMs steer them to their own pharmacies — 72% of drugs with markups over $1,000 per fill are routed this way
💸 In just a few years, they’ve pocketed $7.3 BILLION in profits from inflated prices — money that should have stayed with patients, plan sponsors, and local pharmacies
🚫 This isn’t care coordination. It’s anti-competitive profiteering — and it's happening in your state health plan.
💥 If you’re a teacher, first responder, or public retiree — you’re being told where to fill your meds, not because it’s safer or cheaper, but because PBMs own the pharmacy.
🗣️ This is not healthcare. This is corporate coercion.
🛑 It’s time to STOP the patient steering.
🗣️ Tell your legislators: PBMs are managing PROFITS, not benefits.