For years, Americans have been told that high prescription drug prices are simply the cost of innovation. But for millions of patients struggling to afford medications, that explanation rings hollow. Roughly a third of American adults report difficulty paying for prescription drugs, and many are forced to skip doses, delay refills, or abandon treatment altogether.
The reality is that there is no single villain behind America's drug pricing crisis. Pharmaceutical manufacturers deserve scrutiny for the high prices many Americans pay for prescription drugs, but they are only part of the story. Between drugmakers and patients stand pharmacy benefit managers, or PBMs, some of the most powerful and least understood players in healthcare, with growing influence over which drugs are covered, which companies succeed, and how billions of dollars flow through the prescription drug market.
