Independent pharmacies unable to negotiate fair reimbursement rates against consolidated PBM cartels

Independent and regional pharmacies are systematically squeezed by price-fixing agreements between major pharmacy benefit managers (PBMs), resulting in reimbursement rates that don't cover their costs. Pharmacies lack negotiating power against consolidated PBM duopolies and have no transparent mechanism to challenge anti-competitive pricing, forcing many to operate at losses or close entirely. Current legal remedies are slow and reactive, leaving pharmacies financially devastated while litigation proceeds.