Floridians face high out-of-pocket costs for healthcare. While breakthrough scientific research has changed how we treat – and even cure – health ailments and diseases, the true costs of these drugs and therapies are largely a mystery. Often, states that cover the cost of prescription drugs for state employees and Medicaid enrollees don’t know if they are paying a fair price, local pharmacies face high costs to distribute prescriptions to patients, and patients know very little about what goes on behind the pharmacy counter.

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Pharmacy Benefit Managers (PBMs) are companies that manage the prescription drug benefit for public and private health insurers. Currently, just three PBM corporations control more than 80% of the U.S. market share, virtually eliminating a competitive environment. PBMs were meant to give patients and purchasers leverage when negotiating prescription medicine prices. However, these multi-billion-dollar corporations  fail to pass a very large portion of those savings to the patients, employee health plans, and the public insurance programs that pay the final price.

In reality, a large portion of the negotiated savings never get to the patient; they go back to the PBM.

PBMs are not only keeping savings from patients, but also from pharmacists and state governments, ultimately forcing some local pharmacies out of business. The three PBMs controlling the market are all vertically integrated with major health insurers and affiliated pharmacies, such as CVS, to virtually eliminate competition for small, mom & pop pharmacies. At the same time, a growing number of states have found that they’ve been overcharged by PBMs to the tune of hundreds of millions of dollars.