Dive Brief:

The pharmacy benefit manager marketplace is dominated by a handful of large players, many of which are vertically consolidated with health insurers, according to a new paper from a top medical association.

On average, local PBM markets are highly concentrated across services like rebate negotiation, retail network management and claims adjudication, according to the study from the American Medical Association. And nationally, 77% of people in prescription drug plans are covered by an insurer that’s vertically integrated with a PBM.

The AMA’s paper is the latest in a number of studies finding a lack of competition in the PBM landscape, which experts say could be harming consumers.

Dive Insight:

PBMs, which manage prescription drug benefits for the majority of Americans, wer

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