BESSEMER, Ala. (May 24, 2023) – In a letter sent to one of the largest investors in America’s Big Three pharmacy benefit manager companies (PBMs), American Pharmacy Cooperative, Inc. (APCI) urged Vanguard, Inc., to use its influence to curb abusive PBM practices that increase prescription drug prices for patients.

The letter was sent to Vanguard’s CEO and executive management team because of the firm’s significant investments in UnitedHealth Group, CVS, and Cigna. According to publicly available records,Vanguard is the largest institutional shareholder of UnitedHealth Group and CVS and the second largest institutional shareholder of Cigna. Vanguard owns more than 220 million shares of stock cumulatively among the three companies.

In the letter, APCI details how the large PBMs’ business practices increase costs for patients at the pharmacy counter and highlights the scrutiny these practices are receiving from lawmakers at both the state and federal levels.

“APCI’s explicit request is that Vanguard stand with patients, providers, and lawmakers and demand that large PBMs end these practices that drive up the cost of prescription drugs at the counter, take away patient choice, and create barriers to care that lead to fragmentation, poorer adherence, and poorer patient outcomes,” the letter states.

“Pharmacist, provider, and patient groups have been working to rein in large PBM practices for years. With unprecedented momentum at the federal level, it is time for large investors of publicly traded PBMs to join the fight,” said APCI CEO Tim Hamrick. “PBMs exert tremendous influence on the prices patients pay for prescription drugs while limiting access to a patient’s pharmacy of choice. These issues and many others have gotten too big for any investor to ignore.”

“U.S. and state lawmakers are working hard from a legislative standpoint to reform unfair and opaque PBM practices that result in real and significant financial consequences for patients and taxpayers. From an economic angle, Vanguard – because of its substantial ownership stake in these companies – has an opportunity to be a leader in creating positive change in the PBM industry,” said APCI Director of Healthcare Policy Greg Reybold. “Our hope is that Vanguard’s leadership takes a long hard look at the impact these practices have on patients, payors, providers, and taxpayers and commits to utilizing its substantial position in these companies to bring these practices to an end.”

About APCI

APCI is a cooperative of more than 1,600 independently-owned community pharmacies in 31 states. Established in 1984 and headquartered in Bessemer, Ala., APCI is recognized as a leader in the fight for prescription drug pricing transparency and reform.