August 17, 2026
Alliance: Pharmacy benefit managers drive up prescription costs while keeping consumers in the dark
Health Care Sharing Ministries point to cash-price options and greater consumer choice as alternatives to an opaque prescription drug system
WASHINGTON — The Alliance of Health Care Sharing Ministries today warned that pharmacy benefit managers, or PBMs, can leave Americans paying more for prescription drugs while obscuring how prices are determined and who profits from the system.
The warning follows a recent account by Chris Jacobs, founder and CEO of Juniper Research Group, who described trying for nearly a year to get a straightforward answer about a prescription. Jacobs wrote that his doctor requested a 90-day mail-order supply through CVS Caremark, but the company filled a smaller quantity because the drug was not treated as a maintenance medication under his prescription plan.
Jacobs said he ultimately found that paying cash at a local grocery store pharmacy, using a discount code, cost less for a 90-day supply than CVS Caremark would have charged him for another 30-day prescription through his insurance benefits.
“This story illustrates how PBMs like CVS Caremark can profit by overcharging patients for drugs, and making the prescription drug system more complicated,” Jacobs wrote.
The Alliance of Health Care Sharing Ministries says the problem is compounded because many employers rely on insurance brokers to recommend PBMs without fully understanding the financial relationships among PBMs, insurance carriers and brokerage houses. Many Americans also have insurance policies that do not permit them or their employers to choose a PBM.
“Americans should not need a flow chart to understand what a prescription costs or why paying cash can be cheaper than using an insurance benefit,” said Randall Hultgren, executive director of the Alliance of Health Care Sharing Ministries. “PBMs operate inside a system that is too often complicated, opaque and structured to protect revenue streams instead of giving patients clear choices and competitive prices.”
Health Care Sharing Ministries operate differently from insurance. They allow faith-centered people to join together as a community to share eligible medical expenses. Ministries can also make discounted cash-price programs for prescription drugs available to members, giving consumers another way to compare costs before filling a prescription.
“Consumers deserve to know the real price before they reach the pharmacy counter, and they deserve the freedom to choose the option that best serves their families,” Hultgren said. “Health Care Sharing Ministries demonstrate that health care can involve fewer bureaucratic barriers, more choices and a community committed to helping one another with medical expenses, prayer and encouragement.”
The Alliance of Health Care Sharing Ministries said the Affordable Care Act helped reinforce a highly regulated health care marketplace in which consumers often have limited control over the intermediaries handling prescription benefits. The Alliance is urging consumers and employers to scrutinize prescription pricing, compare cash prices when possible and ask who benefits financially from their PBM arrangements.
“When a cash price is lower than the price generated through an insurance-linked PBM, consumers have every reason to question whether the system is working for them,” Hultgren said. “Transparency and competition should lower costs. Complexity should not become a business model for taking more money from patients.”
Founded in 2007 and headquartered in Washington, D.C., the Alliance of Health Care Sharing Ministries is a 501(c)(6) trade organization representing the common interests of Health Care Sharing Ministries, which facilitate the sharing of health care needs (financial, emotional and spiritual) by individuals and families and their participants. The Alliance engages with federal and state regulators, members of the media and the Christian community to provide accurate and timely information on health care sharing.
To learn more about the Alliance of Health Care Sharing Ministries, visit www.ahcsm.org or follow the ministry on Facebook or Twitter.
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To interview a representative from the Alliance of Health Care Sharing Ministries, contact Hamilton Strategies, Media@HamiltonStrategies.com, Beth Bogucki, 610.584.1096, ext. 105, or Richard Jefferson, rjefferson@hamiltonstrategies.com.
