PBM antitrust cases show up in your renewal
Antitrust cases aren’t just big-company legal drama.
They show up in your renewal.
When the FTC sued the three largest PBMs, it alleged their rebating practices were designed to inflate list prices and shift costs onto plans and patients. Express Scripts just settled. Caremark and OptumRx are still active.
When a hospital system goes from competing to dominating a local market, “negotiation” becomes “take it or leave it.”
That lands in your renewal number.
When the same parent owns the insurer, the PBM, the specialty pharmacy, and parts of the provider network, dollars move in circles.
Plan sponsors are usually the last to see the full picture.
None of this is abstract. It’s the number that goes up every year.
Next week I’ll walk through what plan sponsors should actually be watching as antitrust scrutiny and employer-sponsored plans start to intersect more directly.
It’s an intersection worth watching.
Originally posted on LinkedIn, where the discussion and source links live in the comments.