When massive healthcare companies began merging- insurers buying pharmacies, pharmacies absorbing PBMs- the pitch was simple: “Efficiency will drive down costs.”
That was the promise.
Today, we know better.
- Three companies- CVS Health, Cigna, and UnitedHealth- now control 95% of U.S. prescriptions1.
- The FTC found that these PBMs inflated costs for specialty generics by $7.3 billion over six years2.
- States across the country are trying to unwind this consolidation, passing laws to stop PBMs from owning pharmacies or from steering patients into closed networks3.
Instead of delivering savings, vertical integration has:
- Reduced patient choice: Independent pharmacies and physicians are pushed out of networks.
- Hidden pricing games: Spread pricing and rebate retention make drug costs opaque.
- Raised costs: Multiple studies, including a 2020 RAND analysis, show consolidation leads to price hikes- hospital prices rose nearly 20% after vertical integration4.
This isn’t just a policy issue- it’s personal. Patients are paying more and getting less. Families face fewer options for where and how to receive care. And independent physicians, once the backbone of personalized medicine, are being squeezed out by corporate power.
The solution isn’t another merger or more promises of “efficiency.” It’s:
- Decentralization: Break up the structures that own every link in the care chain.
- Transparency: End hidden rebates and spread pricing to show true costs.
- Competition: Ensure patients have real choices for their providers and pharmacies.
The bigger healthcare gets, the less human it becomes. It’s time to restore balance- before more patients get caught in the middle.
