The maligned and misunderstood player that Big Pharma wants gone



Last week, a bipartisan group of senators introduced legislation on drug prices that specifically targets pharmacy benefit managers, exactly as Big Pharma prefers. Pharmaceutical companies have spent years trying to convince the public and policymakers that PBMs are the bad guys in the prescription supply chain, shadowy middlemen inflating prices and hurting innovation. That narrative is convenient, but it is also wrong. PBMs are introducing competition, eliminating waste, and driving down prices.

Which is precisely why Big Pharma wants them out of the way.

The truth is that pharmacy benefit managers are effective. And that is exactly why drugmakers are going after them.

The pharmaceutical industry spends more money than any other sector to sway government policy. In 2024, it poured $90 million into campaign contributions and nearly $400 million into lobbying — much of it through former government officials now on the payroll. Drugmakers also shelled out a whopping $11 billion on advertising, a sum that conveniently buys more than consumer attention. It pressures media outlets to look the other way, a racket the Trump administration is finally moving to rein in.

After the black eye of the opioid crisis and the COVID-19 debacle, Big Pharma needs a scapegoat for high drug prices. It found one in a quiet, little-known player most Americans have never heard of, much less understood.

But the numbers are clear. A recent study shows pharmacy benefit managers deliver at least $145 billion in net value every year, even after costs. Compared with a system where manufacturers dictate prices, PBMs create an additional $192 billion in value across the economy. That money doesn’t vanish into corporate coffers. It flows back into businesses, households, and the wallets of working Americans.

PBMs accomplish this by negotiating directly with manufacturers and pharmacies. They aggregate buying power for millions of people. They secure rebates and discounts that most individual plans could never get on their own. In 2020, PBM-managed rebate structures created $51 billion in value for patients and plan sponsors. That is a competitive market in action.

PBMs are expected to save health plans and consumers about $1.2 trillion over the next 10 years, averaging $1,154 per person per year. And for every dollar spent on PBM services, the system saves $10 in return. By steering patients toward generics and bio-similars, PBMs helped the health system save $445 billion in 2023 alone. That is what efficiency looks like.

Perhaps more importantly, they improve health outcomes. When patients can afford their prescriptions, they are more likely to take them. That means fewer hospitalizations and fewer emergency room visits. PBM-driven programs have led to as much as a 16% increase in medication adherence and a 10% drop in inpatient admissions.

RELATED:How MAHA can really save American lives

Tom Williams/CQ-Roll Call, Inc via Getty Images

It’s an obvious good to have healthier Americans. But it’s also good for a productive economy.

By lowering premiums and drug costs in public programs, PBMs save taxpayers money as well. This alone accounts for $47 billion in annual savings. And by accelerating patient access to new therapies early in the patent cycle, PBMs support pharmaceutical innovation instead of stifling it.

PBMs currently manage 95% of retail prescriptions and serve 91% of plan participants. That’s because they work. Businesses in the free market use services they value. And they value PBMs because they allow employers to offer more affordable coverage without sacrificing quality.

The truth is that PBMs are effective. And that is exactly why drugmakers are going after them. PBMs bring down net prices and demand accountability. That cuts into Big Pharma’s profit margins. So the industry has launched a campaign to reframe PBMs as a problem rather than a solution.

For example, a Biden-era Federal Trade Commission report that painted PBMs in a negative light should be viewed with skepticism. Even FTC Commissioner Melissa Holyoak emphasized that the report ignores the hard evidence of PBM-driven savings and warned that it was “a premature and deficient report,” adding, “Our job is not to score cheap points for transient political favor.”

“Though facile arguments that rely on ideologically loaded buzzwords such as ‘control’ or ‘power’ may stir emotions and make for entertaining social media posts and television interviews, ideological buzzwords are no substitute for rational, evidence-based research,” Holyoak said.

Sadly, some lawmakers are swallowing Big Pharma’s spin. Bills moving at both the federal and state level would gut PBMs — and hand drugmakers exactly what they want. Even a Brookings Institution analysis found that targeting PBMs won’t lower costs and would only weaken bargaining power against manufacturers.

That isn’t reform. It’s malpractice. Weakening the only players who force price discipline amounts to doing Big Pharma’s bidding at the expense of patients.

This fight isn’t about patients versus middlemen. It’s about competition versus monopoly. It’s about market discipline versus unchecked corporate power.

PBMs work because they negotiate, they drive better drug choices, and they deliver real value. When the most powerful industry in America is desperate to kill them off, you don’t need a think tank study to see what’s at stake. That fact alone tells you everything you need to know.

How Leftist Clubs For Government Employees Work Against Red State Voters

There are dozens of organizations representing what effectively amounts to a left-wing shadow government guiding states in an increasingly leftist direction.

How leadership failures fueled the flames in the Golden State



America is no stranger to natural disasters. But it’s not the fires, floods, or earthquakes that are the most devastating — it’s the repeated failures to learn from them, prevent them, and take responsibility for the damage.

My heart goes out to the families who have lost homes, cherished memories, and livelihoods. But if we’re going to help California rebuild and prevent future disasters, we need to confront some uncomfortable truths about leadership, responsibility, and priorities.

California — ironically, in the name of environmentalism — continues to ignore solutions that would protect both the environment and its residents.

While Californians continue to face heart-wrenching losses, those who have the power to enact change are mired in bureaucracy, regulation, and ideologies that do nothing to protect lives or preserve the land. The result? A state that keeps burning, year after year.

Where did all the water go?

We all know that water is essential to life. When NASA searches for signs of life on other planets, it looks for water. Yet, California has spent decades neglecting its water infrastructure. The state hasn’t built a new major reservoir since 1979 — over 40 years ago. Back then, California’s population was roughly half what it is today. Despite massive population growth, the state’s water storage capacity has remained frozen in time, woefully inadequate for current needs.

Moreover, billions of gallons of rainwater flow straight into the ocean every year because no infrastructure exists to capture and store it. Imagine how different things could be if California had built reservoirs, aqueducts, and desalination plants to secure water for its dry seasons.

Water is life, but the state’s failure to prioritize this essential resource has put lives and ecosystems at risk.

Misplaced priorities and critical leadership failure

This neglect of critical infrastructure is part of a larger failure of vision, and in California, the consequences of that failure are on full display.

Consider the progressive leadership in Los Angeles, where the mayor cut the fire department’s budget to fund programs for the homeless, funneling money to NGOs with little oversight. While helping the homeless is a worthy cause, it cannot come at the expense of protecting lives and property from catastrophic fires. Leadership must put safety and well-being over political agendas, and that’s not happening in Los Angeles.

The same misplaced priorities extend to environmental policies. Progressive leaders have blocked sensible forest management practices, prioritizing dead trees over living creatures. They reject controlled burns, forest thinning, and other commonsense measures, bowing to the demands of activists rather than considering real solutions that would protect those they govern.

California’s wildfire crisis is, in many ways, a man-made disaster. Yes, factors like Southern California’s dry climate, strong Santa Ana winds, and little rain play a role, but the biggest contributing factor is poor land management.

The forests are choked with dry brush, dead trees, and vegetation that turn every spark into a potential inferno. The crisis could have been mitigated — if only the state had made forest management and fire prevention a higher priority.

Finland and Sweden, for example, understand the importance of maintaining healthy forests. These countries have perfected the art of clearing underbrush and thinning trees sustainably, turning potential fire fuel into biomass energy. This approach not only reduces the risk of wildfires, but it also creates jobs, boosts the economy, and improves the ecosystem. And yet, California — ironically, in the name of environmentalism — continues to ignore these solutions that would protect both the environment and its residents.

We need to stop pretending that something as devastating as the Palisades and Eaton fires are just “part of life” and hold leaders accountable.

Insurance rules put California residents at risk

California faces another major and often overlooked liability when it comes to natural disasters: insurance.

California’s ongoing disasters make the state an uninsurable risk. Insurance companies are pulling out because the odds of widespread devastation are just too high. This creates a vicious cycle: With private insurers gone, the government steps in to subsidize high-risk areas. This enables people to rebuild in fire-prone zones, perpetuating the destruction. The solution isn’t more government intervention; it’s better decision-making.

This doesn’t mean abandoning people to their fate, but we must address the root of the problem: California’s inadequate disaster preparedness and poor land management. If the state continues to resist commonsense solutions like forest thinning, controlled burns, and better zoning laws, no amount of insurance or government assistance will ever be enough to mitigate the losses. The cycle will repeat until the costs — financial and human — become unbearable. It’s time to stop pretending the risk isn’t real and start making decisions that reflect the reality of California’s landscape.

What’s the solution? California’s government needs to put its people over harmful political agendas that put its residents at risk. Start by managing your forests. Implement controlled burns, remove dead trees, and clear underbrush.

But how you vote matters. California’s progressive policies have focused on political correctness and ideology instead of practical, lifesaving solutions. Until voters hold leaders accountable, the cycle of destruction will persist.

Want more from Glenn Beck? Get Glenn's FREE email newsletter with his latest insights, top stories, show prep, and more delivered to your inbox.

Americans Are Betting On Ozempic Over Willpower To Make America Healthy Again

Americans are likelier to gravitate towards new weight-loss drugs over lifestyle interventions for weight loss.

Warren’s Reaction To UnitedHealthcare CEO Murder Cements Democrats As Party Of Violence

[rebelmouse-proxy-image https://thefederalist.com/wp-content/uploads/2024/12/Screenshot-2024-12-11-at-11.40.39 AM-e1733938904138-1200x675.png crop_info="%7B%22image%22%3A%20%22https%3A//thefederalist.com/wp-content/uploads/2024/12/Screenshot-2024-12-11-at-11.40.39%5Cu202fAM-e1733938904138-1200x675.png%22%7D" expand=1]Sen. Elizabeth Warren is no stranger to encouraging or excusing violence in the name of advancing her political agenda.

Biden’s Spendy Election Year Insurance Bailout Will Save Seniors Just $1.63 Per Month

Rather than facing the consequences of the law they rammed through Congress, the Biden administration decided to tap taxpayers instead.

Kamala Harris Always Planned To Take Away Your Health Coverage

Under a Kamala Harris presidency, Americans who like their health insurance would lose it — and pay for illegal aliens' coverage.

Prepare For A Slow, Spendy Baltimore Bridge Rebuild That Doesn’t Satisfy Anybody

Engineering priorities have become secondary to other interests, which is why we cannot have nice things quickly at a reasonable cost.

Two-Time Bone Cancer Survivor Debunks Biden’s ‘Affordable’ Health Care Policies

If regulators wanted to crack down on 'junk insurance' plans, they should do something about Obamacare itself.

New Government Report Shows Trump Is Right About ‘Cutting’ Medicare Fraud

The next time any politician lodges a silly attack over 'cutting' Medicare, point out the waste and ineffective bureaucracy in these programs.