“If they were stand-alone companies, the three biggest P.B.M.s would each rank among the top 40 U.S. companies by revenue. The largest, Caremark, generates more revenue than Ford or Home Depot.” https://www.nytimes.com/2024/06/21/business/prescription-drug-costs-pbm.html?smid=nytcore-ios-share&referringSource=articleShare

// PBMs are a reaction to the monopoly power of drug companies, theoretically serve kind of as unions of drug buyers to exert bargaining power + secure lower prices. but they are not unions, they are for-profit firms. they collude not to trim the fat but to increase and share it.