The war of words over pharmacy benefit managers has moved from Congress and regulatory agencies to the streets. Late last week, dozens of demonstrators protested outside the headquarters of Express Scripts in St. Louis.

Protestors waved signs, shouted slogans and gave speeches at a makeshift podium across the street from the nation's second-largest PBM. Protestors argued that patients are being harmed by PBM practices that prevent them from using their preferred pharmacies or require them to first try less-expensive drugs before approving the ones their physicians want to prescribe, even if those less expensive drugs are inappropriate.

"So many patients are not getting their medications on time," said Loretta Boesing, founder of the patient advocacy group Unite for Safe Medications and organizer of the protest. "We need options to use their local pharmacies in our coverage. We need Express Scripts to stop being so greedy. This has to stop. We cannot allow this to happen to our pharmacy and medication access here in America."