"Express Scripts and Caremark are pharmacy benefit managers (PBMs) that administer prescription drug benefits for many health insurance companies and TRICARE. While you may have health insurance from Anthem, Aetna or another insurer, your pharmacy benefits are usually handled by these PBMs or their competitors. PBMs also set the formulary for everyone under their prescription drug benefit"

These PBMs make the rules and take rebates paid by the drug manufacturers for requiring/guiding people to specific medications. Those rebates are worth billions of dollars each year. These companies are in desperate need of regulation. They are a monopoly. They control the health and money of millions of people and nobody knows that they are the problem.

The high cost of drugs in this county is a problem, but the biggest reason for this problem is the PBM industry.