AlignRx Spotlights PBM Dominance Squeezing Community Pharmacies
Los Angeles – October 01, 2026 -- Three pharmacy benefit managers—CVS Caremark, Optum Rx, and Express Scripts—processed roughly 80% of U.S. prescription claims last year, a concentration that AlignRx says is squeezing independent pharmacies out of the market. The nation's largest independently owned Pharmacy Services Administrative Organization (PSAO) is the subject of a forthcoming feature on the public television series All Access with Andy Garcia, which examines the reimbursement pressures facing community pharmacies nationwide.
Vertically integrated PBMs leave pharmacies reimbursed below drug cost
The feature details how market consolidation among the three dominant PBMs has created a vertically integrated system in which patients face higher out-of-pocket costs and reduced choice. Community pharmacies, AlignRx says, are often reimbursed less than the cost of the medication they dispense, straining their ability to stay open.