SopranoRX: The PBM Mafia, Revisited

The shake down that never stops, and what you can do about it.

“There used to be rules!”

—Junior Soprano,

fictional crime boss of the North Jersey Mafia on HBO’s “The Sopranos”

Welcome to the Frontier Psychiatrists. What follows is an ambitious piece of writing. This took over three months and 50 hours to write. I’m a child and adult psychiatrist. I have come to believe understanding healthcare payments is the key to understanding why healthcare is so careless and awful.

This article was published on July 10th, 2023. Since then, the issue of PBMs has received extensive coverage, including this past weekend's coverage by the NY Times. Pro Publica launched its PBM accountability project. The FTC added yet more oversight to its agenda. Quoting Lina Khan:

The stakes of corporate monopolization are highest in healthcare. Despite the enormously consequential role they play, PBMs operate in complex and obscure ways that have let them fly under the radar….

So far, the PBMs have not fully complied with our orders to turn over documents and data. FTC ord…