PBM Origin: How 3 Companies Control Your Drugs #shorts
In this short monologue, Jacob Fuchs explains how pharmacy benefit managers (PBMs) emerged from a practical solution to the administrative burden of processing prescription claims in the 1960s. Insurers began covering prescriptions, leading to a flood of paper claims and manual eligibility checks. Companies stepped in to handle the paperwork, and one created a plastic drug‑benefit card, establishing the PBM model. Over time, because PBMs processed every claim, they gained visibility into every prescription, price, and pharmacy, allowing them to decide which drugs were covered—a discretion that proved financially valuable. Today, three PBM companies control roughly 80% of all prescription claims in the United States, despite not manufacturing drugs or treating patients. Fuchs emphasizes that this concentration resulted from a series of ordinary industry decisions—not a single illegal act or conspiracy.
