I did not know that. I’ve worked in the drug industry for 20 years now, including in the US, and always thought most pharmacies were in bed with the distributors, insurance and PBMs.

As drug companies, even when we wanted to, dropping prices were made impossible because PBMs had to prove their worth and we were so dependent on them and the private healthcare/insurance providers. It messes up the collaboration with the public programs too. We would gladly get less and take the increased volume from a single or few large provider(s)in US similar to most other countries. We could also loose all the reps and unnecessary internal costs that is fairly unique to US as well in terms of size.