Prescription Benefit Managers (PBMs), are middlemen that manage the lists of covered medicines for public and private health insurers. PBMs determine which medicines will be covered by health insurance plans and how much patients will pay for their prescription drugs.

The costs of prescription medications are rising. It’s no coincidence that while out-of-pocket drug costs are rising, PBM profits are increasing. And yet the process of pricing our medications is unknown to many Americans– putting consumers at a disadvantage. Across the country, patients and their employers are too often put in a position where they pay more than is necessary because of our flawed marketplace controlled by PBMs.

The PBM industry originally existed to help employers manage prescription drug costs and benefits overall. In reality, PBMs are diverting potential prescription drug savings away from patients and into high profits in the prescription drug supply chain. In fact, three major PBM companies make up 75% of the market. These PBMs have become so profitable over time, they are now amongst the Fortune 25 companies – ranked higher than the drug manufacturers whose prices they had promised to control.

It’s time to advance state policy solutions here in Massachusetts that help create more transparency around how PBMs operate ,and address the ways PBMs profit at the expense of independent pharmacies, patients, employee health plans, and taxpayers.