The debate over prescription drug costs in the United States is heating up, with pharmacy benefit managers (PBMs) facing intense scrutiny. CVS Health CEO David Joyner recently stepped into the discussion, strongly defending PBMs despite criticism from lawmakers, regulators, and pharmaceutical companies.

During CVS Health’s fourth-quarter earnings call on February 12, 2025, Joyner argued that PBMs are essential in managing and reducing drug costs. These organizations negotiate prices, establish formularies, and process prescription claims, handling nearly 80% of all prescriptions in the country. While critics argue that PBMs contribute to rising drug prices, Joyner placed the blame on pharmaceutical manufacturers, accusing them of monopolistic pricing practices.

“Pharmacy benefit managers are the only part of the drug supply chain solely focused on lowering costs,” Joyner stated. According to him, PBMs negotiate crucial savings that would otherwise be absorbed by pharmaceutical companies. He cited a massive $21 billion increase in brand-name drug prices within the first three weeks of January 2025, though he did not provide a specific source for this figure.

Despite Joyner’s defense, PBMs continue to face widespread criticism. Lawmakers from both parties, including former President Donald Trump, have expressed interest in regulating these entities. Opponents argue that while PBMs negotiate rebates with drug manufacturers, they often keep a significant portion of these savings instead of passing them on to patients. Additionally, concerns have been raised that PBMs underpay pharmacies while overcharging insurance providers, further complicating healthcare affordability.

The powerful pharmaceutical lobbying group PhRMA responded to Joyner’s remarks with skepticism, arguing that PBMs themselves contribute to rising drug costs. This debate has extended beyond corporate discussions and into government investigations, with bipartisan lawmakers, state attorneys general, and the Federal Trade Commission (FTC) all examining PBM practices closely.

Despite Joyner’s strong defense of the industry, the scrutiny on PBMs is expected to intensify. With increasing legislative and regulatory efforts aimed at curbing high prescription costs, significant reforms could be on the horizon.

The ongoing battle over drug pricing highlights the complexity of the American healthcare system. Joyner maintains that PBMs generate more than $100 billion in value for the industry. However, a crucial question remains: do these savings ultimately benefit patients, or are they lost within the wider healthcare system? As investigations continue, the public will be watching closely to see whether meaningful change comes from this intense policy debate.