Pharmacy-benefit managers in the US

In the USA, 4,100,000,000,000. $ is spent yearly on health-care. This is 17% of GDP, a rate almost twice the average of OECD countries. The middlemen take 45% of America's helth-care bill. UnitedHealth Group made 324,000,000,000 $ in revenues last year. Just three PBMs handled 80% of all prescription claims. Between 2013 and 2023, the nine health care giants spent 325,000,000,000 $ over 320 mergers and acquisitions. Increasingly, vertical integration brings in the same group : insurance, clinics, hospitals and pharmacies. The latest entry into medical care is Amazon. Its Amazon Clinics offer virtual consultations and RxPass offers cheap generic drugs to Amazon Prime subscribers.