It's It's a tough time to be a middleman in the U.S. pharmacy business.
Jeff Bezos is teaming up with two fellow billionaires in what could be a prelude to bigger plans to undercut the dominance of intermediaries in the country's complex health-care system. Pharma companies are trying to shift the blame onto them for soaring drug prices. And costly new medicines are getting approved at a record pace pace by regulators in Washington.
In response, the middlemen known as pharmacy-benefit managers, or PBMs, are getting more aggressive with the tactics they use to control costs. Express Scripts Holding Co., CVS Health Corp. and UnitedHealth Group Inc.'s OptumRx are increasingly denying coverage of some drugs, negotiating discounts on others or requiring high co-pays for expensive treatments.
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