Sector of intermediaries managing prescription drug benefits, formularies, and reimbursements for health insurers.
1 take · first discussed May 17, 2025
Private company — no public price to score. We track what they said; valuation-mark tracking is on the roadmap.
Based on the supplied material, Friedberg holds a negative view of the PBM sector with high conviction, arguing that the three dominant players — CVS Caremark, Express Scripts, and OptumRx — function as exploitative middlemen that extract excess profits through opaque pricing practices. He cites an estimated $7.3 billion in excess profits generated between 2017 and 2022, particularly on specialty generic drugs, as evidence of systemic abuse. His core position is that PBMs should be removed from the drug pricing system entirely rather than reformed. Only one host's thesis was provided, so no cross-host agreement or disagreement can be assessed.
Friedberg argues PBMs (CVS Caremark, Express Scripts, OptumRx) are exploitative middlemen generating excess profits through opaque markups and should be removed from the drug pricing system.
Between 2017 and 2022, the estimate that these companies generated $7.3 billion in excess profit by marking up prices. On specialty generic drugs. The list goes on, on kind of the egregious behavior and the role that they play as middlemen”1:35:06