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The Pharmaceutical Power Play: How Insurance Giants are Dominating the Drug Market

In recent years, the largest U.S. health insurers have extended their influence into the pharmaceutical industry by acquiring pharmacy benefit management (PBM) companies, significantly altering the healthcare landscape. PBMs act as intermediaries between drug manufacturers, pharmacies, and health insurers, playing a crucial role in determining drug prices and coverage. Major mergers, such as CVS’s acquisition of Aetna and Cigna’s purchase of Express Scripts, have resulted in CVS, Cigna, and UnitedHealth controlling nearly 80% of the PBM market. This consolidation has given these insurers enormous leverage over drug prices and formularies, raising concerns about the lack of transparency in PBM operations. Critics argue that the savings negotiated by PBMs are often not passed on to consumers but are instead used to increase the profits of the insurers. The dominance of these few companies in both the insurance and pharmaceutical markets has sparked calls for greater regulation to ensure that consumers are not unfairly burdened with high medication costs due to the opaque practices of PBMs .

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Why Ownership Matters:

At Haven Home Health and Hospice, we are proud to be the last locally-owned, independent, and clinician-led provider of home-based care in our region. While that may sound like a simple fact, it’s actually a defining difference—one that matters deeply to the quality of care our patients receive every day. In recent years, private equity firms and large corporate healthcare chains have rapidly bought out home health and hospice providers across the country, including right here in our community. What we’ve seen in the aftermath is troubling: rapid turnover of staff, shrinking time spent with patients, and decisions driven more by profit margins than by compassion, dignity, and clinical excellence. 

When ownership shifts from caregivers to corporations, priorities shift too. 

We believe healthcare should never be treated like a commodity. That’s why we’ve remained committed to local, clinician-led ownership—because we answer to patients, not shareholders. Our leadership is hands-on, involved, and invested in every life we touch. We believe that meaningful care takes time, intention, and heart—and it starts with the people who make the decisions. As owners who are also licensed clinicians, we understand the weight of the responsibility we carry. Our patients are not numbers in a spreadsheet. They are parents, grandparents, neighbors, and friends. And we believe they deserve the kind of care we’d want for our own families. We will continue to stand against the corporatization of healthcare, and we invite you to stand with us. Whether you’re a patient, a referral partner, or a member of the community, your trust makes it possible for us to preserve something rare and essential in today’s healthcare system: personalized, human-centered care. Because in the end, ownership isn’t just about who signs the papers—it’s about who shows up when it matters most.

– John Ray, Founder

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