"PBMs play an oversized role in federal health care programs as large corporate middlemen. The United States is the only country in the world that utilizes PBMs, and drug prices in this country remain exponentially higher compared to other countries. PBMs determine which pharmacies patients may choose by creating provider networks, determine which drugs patients can be prescribed by creating drug formularies, and determine how much patients pay at the pharmacy counter for their medications. Because of their anticompetitive practices and our nation's ever-increasing drug costs, greater scrutiny over PBM business tactics is imperative."