Pharmacy Benefit Managers (PBMs) play a powerful role in the U.S. healthcare system by managing prescription drug benefits for insurers, employers, and government programs. However, their complex pricing models, rebate structures, and reimbursement practices have drawn criticism for contributing to rising healthcare costs and the closure of corporate and independent pharmacies. This has led to financial strain on large and small pharmacies, forcing many to shut down, which reduces patient access to essential medications and care—especially in underserved communities—while doing little to reduce out-of-pocket costs for consumers.

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