Here’s why Americans pay more for prescriptions than they should…

20 Feb 2026 · 1 min

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In this commentary, the speaker argues that the primary reason prescription drugs cost up to ten times more in the United States than elsewhere is not research expenses but the influence of pharmacy benefit managers (PBMs). PBMs act as intermediaries that negotiate drug prices, then mark them up, with insurers covering the markup and patients paying the copay. The speaker claims PBMs also own pharmacies and have stakes in insurance companies, allowing them to control the entire supply chain and inflate prices at every level. Unlike other countries that regulate drug prices, the U.S. lacks such controls because pharmaceutical companies spend billions lobbying Congress. The result is that Americans often ration essential medicines like insulin, skip doses, or face bankruptcy due to medical bills, while the same drugs are affordable abroad. The speaker frames this as legalized extortion and a hostage‑taking of health for profit.

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Prescription drugs cost 10 times more in America than anywhere else. And it's not because of research costs. The problem is pharmacy benefit managers. They're middlemen between you and your medication. These companies negotiate drug prices, then they mark them up. Insurance pays the markup, you pay the copay. But here's the scam. PBMs own the pharmacies. They own the insurance companies. They control every step, so they inflate prices at every level. A drug that costs $10 to make sells for 300. Other countries regulate drug prices. America doesn't, because pharmaceutical companies spend billions lobbying Congress. The result? Americans ration insulin, skip medications, go bankrupt from medical bills. Meanwhile, the same drugs are affordable everywhere else. Same formula, same manufacturer, just different prices. This is legalized extortion. Your health is being held hostage for profit.