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News
A new AMA report reveals the four largest pharmacy benefit managers (PBMs) now control 75% of the U.S. market, up from 70% in 2022. Local PBM markets are even more concentrated, hitting 94% in 2024. The AMA is calling for greater transparency and accountability to ensure patients — not corporate giants — benefit from the system.
A new report from the American Medical Association (AMA) reveals that the four largest pharmacy benefit managers (PBMs) now control 75% of the U.S. market — up from 70% in 2022. PBMs are the powerful middlemen who negotiate drug prices between manufacturers, insurers, and pharmacies, and their growing dominance is raising serious antitrust concerns.
The AMA's analysis, based on 2024 Decision Resources Group data, also found that local PBM market concentration surged from 82% to 94% over the same period. Vertically integrated insurers and PBMs now manage prescription drug benefits for 69% of Americans across commercial and Medicare Part D plans — a setup critics say may prioritize corporate interests over patient savings.
By the Numbers:
Why it matters: When a handful of companies control the majority of prescription drug management, patients may face higher costs and fewer choices. The AMA is urging regulators to scrutinize mergers and demand greater transparency to ensure PBM markets actually work in patients' favor.
