We take a deep dive into the lesser-known industry of “pharmacy benefits managers” (PBMs) which are parasitical companies that sit in the middle of the incredibly consolidated and vertically integrated market of pharmaceuticals <=> hospitals <=> insurers <=> pharmacy benefits managers <=> pharmacies. Through the simple administrative business of making lists of drugs and networks of pharmacies, PBMs have managed to carve out a multi-billion dollar rent-seeking industry premised on controlling (and jacking up) how much drugs cost and where you can get them—and extracting as much money as possible from people who need those drugs.

••• Timeline of FTC lawsuit against PBMs and relevant documents: https://www.ftc.gov/legal-library/browse/cases-proceedings/221-0114-caremark-rx-zinc-health-services-et-al-matter-insulin

••• Concurring Statement of Commissioner Andrew N. Ferguson https://www.ftc.gov/system/files/ftc_gov/pdf/Ferguson-Statement-Pharmacy-Benefit-Managers-Report.pdf

••• Market Power and Inequality: The Antitrust Counterrevolution and Its Discontents | Lina Khan and Sandeep Vaheesan https://scholarship.law.columbia.edu/faculty_scholarship/2790/

••• Inside the Mafia of Pharma Pricing | Matt Stoller https://www.thebignewsletter.com/p/inside-the-mafia-of-pharma-pricing

••• A brief look at current debates about pharmacy benefit managers https://www.brookings.edu/articles/a-brief-look-at-current-debates-about-pharmacy-benefit-managers/

Standing Plugs:

••• Order Jathan’s new book: https://www.ucpress.edu/book/9780520398078/the-mechanic-and-the-luddite

••• Subscribe to Ed’s substack: https://substack.com/@thetechbubble

••• Subscribe to TMK on patreon for premium episodes: https://www.patreon.com/thismachinekills

Hosted by Jathan Sadowski (bsky.app/profile/jathansadowski.com) and Edward Ongweso Jr. (www.x.com/bigblackjacobin). Production / Music by Jereme Brown (bsky.app/profile/jebr.bsky.social)