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Max (just Max) is the host of Unfucking the Republic (UNFTR), one of our favorite podcasts. UNFTR publishes intensively-researched deep dives into some of the most important issues in the world. One of their most recent investigations is into Pharmacy Benefit Managers (PBMs), an insidious cartel that has wormed its way deep into the basic structure of the American healthcare system. Today Max joins to explain what PBMs are, why they're hurting small pharmacies, and what needs to happen to curtail their influence. Nathan discusses the case of a family-owned pharmacy in his own hometown, Davidson Drugs in Siesta Key, Florida, which shut down after 65 years and blamed PBMs in part for making it impossible to continue operating.

The video version of UNFTR's report is here. A written version is here. The NYT ran an article on the subject a couple of days ago as well.

"Most people probably haven’t heard of the term Pharmacy Benefit Manager (PBM). But in the healthcare industry, PBM has become a four letter word, unless, of course, you are one. In which case, you’re killing it right now. And you have been for about 20 years. PBMs aren’t anything new. In fact, they’ve been around since the 1960s. But over the last two decades, these administrative organizations have become so big and unwieldy that they drive hundreds of billions of dollars in revenue each year. Just how big have PBMs gotten in the past few years? Big enough that the three largest ones are all in the top 15 largest companies in the United States." - "Pharmacy Benefit Managers, The American Drug Cartel," UNFTR