Vertical integration between health insurance companies and PBMs is leading to anticompetitive practices that make it unaffordable or impossible for self-funded employer health plans to switch to alternative PBMs, the newer PBMs argue.
These alternative PBMs are pushing for federal policy solutions to this dynamic, such as a ban on health care companies charging each other data integration fees.
The push by the alternative PBMs comes as new survey data shows that overall satisfaction with PBMs, particularly the bigger players, is at a decade-long low and as CBO has found that savings on drug prices generated from vertical integration may not be reaching patients.

‘Alternative' PBMs Say Vertical Integration Unfairly Carving Them Out Of The Game

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