you should really look up the profit margins of the largest PBM's, but they are now wholely owned by large insurance companies, or pharmacies. They are the middle men, and get a cut (and often rebates for selling over a certain amount)
The profit margins of UNH/CVS/Cigna/Elevance/Humana/etc are 2% to 3%.
The PBMs are departments of these companies, hence they don’t have profit margins. Prime Therapeutics is owned by the various non profit Blues.
I don’t see how they are relevant. If they are earning more money from medicine, then it is being used to subsidize premiums.
There is a reason the market cap for almost all the pharmaceutical companies are bigger than the managed care organizations. UNH is slightly different because they sell far more high margin healthcare rather than just low margin managed care services.
https://www.drugchannels.net/2025/03/the-top-pharmacy-benefi...