It should be abundantly clear that APhA has several bones to pick with big pharmacy benefit managers (PBMs). These PBMs, operating under the guise of altruism, paint themselves as saints who work to lower prescription drug prices for the masses. Instead, they actively game the system by knocking out pharmacy competitors, reducing patient access to medicines and pharmacist services, and ripping off patients, employers, and taxpayers.

In June of 2018, after months of intense pressure from the Ohio Pharmacists Association, Ohio state lawmakers, and Columbus Dispatch investigative journalists, the Ohio Department of Medicaid released a blockbuster report showing that PBMs working on behalf of Medicaid managed care plans charged the state $224 million in hidden spread pricing. 

It was the summer of 2020, and COVID-19 had pulled back the curtain on historic inadequacies in the American health care system—too little personal protective equipment, an unreliable drug supply chain, rampant health inequities, and a lack of coordination between the government, public health officials, and health care providers and facilities.