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With both spread pricing and rebate retention, PBMs retain a portion of the fees paid to them and do not pass those on to clients. These practices incentivize more expensive medications, thereby generating higher revenue for PBMs and potentially inflated drug prices for patients. Additionally, as can be seen in Figure 19, there is limited competition within the PBM market, with three PBMs managing approximately 80 percent of all prescription claims in 2024

Flagler obtained $100,000 from a relative on the condition that Flagler be made a partner

more recently at the turn of the 21st Century, as research into smoking was being conducted, scientists and doctors found that smoking was extremely bad for the body- both mentally and physically

Changes in Daily Life Daily activities can become more difficult as the condition worsens

Further research should monitor the sale of flavor capsule cigarettes and use of flavors to attract new smokers, globally