In the heart of the country’s opaque drug-pricing system, shadowy pharmacy middlemen known for jacking up consumers’ drug costs are also crushing independent pharmacies. They’re doing so by slashing reimbursement rates for small drugstores while paying exponentially higher rates to corporate pharmacies. 

These pharmacy benefit managers (PBMs) threaten the continued existence of what’s left of the country’s independent pharmacy industry — and endanger the estimated 15 million individuals nationwide who rely on independent drugstores for their medications. 

In March, federal bills curbing these companies’ power failed to make it into the federal funding package after industry lobbyists spent $15.4 million on this legislation and other matters. But states are continuing to fight for legislative reform.