Consolidation in the US health-care sector has been rising over the past two decades, with mergers and acquisitions of national players occurring at multiple levels of the supply chain, including pharmacies. The pharmacy marketplace has undergone substantial changes, with vertical and horizontal consolidation, independent pharmacies facing increasing challenges, the growth of specialty pharmacies, and the exponential presence and influence of pharmacy benefit managers (PBMs). The landscape is complex, with conflicting views and theories on the impact of these market changes, and whether they are driving up cost and out-of-pocket expenses for patients with cancer.
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