The Federal Trade Commission today released a scathing report on how pharmacy benefit managers (PBMs) profit at the expense of patients by inflating drug costs and squeezing independent pharmacies. In the report, the FTC details how vertical integration and concentration has enabled the six largest PBMs to manage nearly 95% of all prescriptions filled in the United States.

“The FTC’s interim report lays out how dominant pharmacy benefit managers can hike the cost of drugs — including overcharging patients for cancer drugs,” FTC Chair Lina M. Khan said. “The report also details how PBMs can squeeze independent pharmacies that many Americans — especially those in rural communities — depend on for essential care. The FTC will continue to use all our tools and authorities to scrutinize dominant players across healthcare markets and ensure that Americans can access affordable health care.”

The report finds that PBMs wield enormous power over patients’ ability to access and afford their prescription drugs, allowing PBMs to significantly influence what drugs are available and at what price. This can have dire consequences, with nearly 30 percent of Americans surveyed reporting rationing or even skipping doses of their prescribed medicines due to high costs, the report states.

Read the FTC report in its entirety here.