Patreon Preview – 404. The Parasites that Control Pharmaceutical Prices
May 7, 2025
Delve into the shadowy world of pharmacy benefit managers (PBMs) and their role in skyrocketing drug prices. Discover how these companies profit by acting as middlemen, influencing access to medications like insulin. The discussion also sheds light on the FTC's investigation into these practices and the urgent need for greater accountability. Get ready to unpack the complex jargon of the pharmaceutical industry and understand the troubling wealth transfer affecting patients and their wallets.
08:19
forum Ask episode
web_stories AI Snips
view_agenda Chapters
auto_awesome Transcript
info_circle Episode notes
insights INSIGHT
PBMs Inflate Drug Prices
Pharmacy benefits managers (PBMs) are parasitic middlemen inflating drug prices and restricting access in the healthcare market.
Their capture of the pharmaceutical chain fosters an entrenched, costly system that harms patients needing life-saving medications.
insights INSIGHT
Shield of Boringness Explained
The healthcare industry's complexity, especially PBMs, serves as a "shield of boringness" concealing simple parasitic wealth extraction.
This complexity intentionally hides the direct influence PBMs have on healthcare costs and drug price inflation.
insights INSIGHT
Unmasking Complex Industries
Complex industries like PBMs discourage public understanding through jargon to mask harmful practices.
Piercing this shield is essential to expose and challenge these predatory market structures.
Get the Snipd Podcast app to discover more snips from this episode
We take a deep dive into the lesser-known industry of “pharmacy benefits managers” (PBMs) which are parasitical companies that sit in the middle of the incredibly consolidated and vertically integrated market of pharmaceuticals <=> hospitals <=> insurers <=> pharmacy benefits managers <=> pharmacies. Through the simple administrative business of making lists of drugs and networks of pharmacies, PBMs have managed to carve out a multi-billion dollar rent-seeking industry premised on controlling (and jacking up) how much drugs cost and where you can get them—and extracting as much money as possible from people who need those drugs.
••• Timeline of FTC lawsuit against PBMs and relevant documents: https://www.ftc.gov/legal-library/browse/cases-proceedings/221-0114-caremark-rx-zinc-health-services-et-al-matter-insulin
••• Concurring Statement of Commissioner Andrew N. Ferguson https://www.ftc.gov/system/files/ftc_gov/pdf/Ferguson-Statement-Pharmacy-Benefit-Managers-Report.pdf
••• Market Power and Inequality: The Antitrust Counterrevolution and Its Discontents | Lina Khan and Sandeep Vaheesan https://scholarship.law.columbia.edu/faculty_scholarship/2790/
••• Inside the Mafia of Pharma Pricing | Matt Stoller https://www.thebignewsletter.com/p/inside-the-mafia-of-pharma-pricing
••• A brief look at current debates about pharmacy benefit managers https://www.brookings.edu/articles/a-brief-look-at-current-debates-about-pharmacy-benefit-managers/
Standing Plugs:
••• Order Jathan’s new book: https://www.ucpress.edu/book/9780520398078/the-mechanic-and-the-luddite
••• Subscribe to Ed’s substack: https://substack.com/@thetechbubble
••• Subscribe to TMK on patreon for premium episodes: https://www.patreon.com/thismachinekills
Hosted by Jathan Sadowski (bsky.app/profile/jathansadowski.com) and Edward Ongweso Jr. (www.x.com/bigblackjacobin). Production / Music by Jereme Brown (bsky.app/profile/jebr.bsky.social)
This Machine Kills