Author here. Issue #4 is now live — pharmacy benefit managers. Three companies process 80% of US prescriptions. The FTC spent two years investigating them and

Author here. Issue #4 is now live — pharmacy benefit managers. Three companies process 80% of US prescriptions. The FTC spent two years investigating them and documented $7.3B in specialty drug markups at PBM-owned pharmacies alone. Ohio's state auditor found $224.8M in spread pricing extracted from one state's Medicaid program in a single year. Six mechanisms, $30B/year booked conservatively. Running total across four issues: $128.6B. github.com/rexrodeo/american-healthcare-conundrum