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Over the last decade, however, Minnesota has lost more independent pharmacies than any other state. The demise of independent pharmacies in Minnesota and many other places is being hastened by another group of businesses — the PBMs.

The document from Allina Health arrived in February, stating the 61-year-old Woodbury resident owed the hospital a staggering sum — $155,493. It made no sense, Christensen said. He had coverage through his employer from a reputable health insurer. And the need for the care was undeniable; Christensen was hospitalized for

In theory, pharmacy benefit managers like to recommend generic drugs and keep prices lower than brand-name pharmaceuticals. But it doesn’t always work out that way when the same company owns a PBM and the retail pharmacy — it can be in the company’s interest to keep prices higher.

Today, United is the fifth-largest public company in the U.S., bigger than JPMorgan Chase. Its insurance products serve 50 million members, more than the population of Spain, and its $186 billion health services division, Optum, has 103 million patients, more than Vietnam’s population. Earnings came to $28.4 billion last year,

Underpayment from Caremark has caused many non-CVS pharmacies to close, creating “pharmacy deserts” in many urban neighborhoods and rural areas. CVS Health has been able to achieve and abuse its power through a series of mergers and acquisitions. Had our existing antitrust laws — such as the Clayton Act —

Three major companies control 80% of the prescription-drug market: Optum, ExpressScripts, and CVS Caremark. These companies leverage their dominance to engage in practices like “patient steering,” which is requiring patients to fill prescriptions at their pharmacies, even when it’s less convenient. “Spread pricing” is another tactic, whereby PBMs reimburse pharmacies