How Private Equity Is Buying Up Pharmacy Benefit Managers

The Buyout Show with Fexingo: Private Equity, Roll-Ups, and Business Acquisitions · Jul 8, 2026 · 8m · transcript

Private equity has quietly consolidated a huge chunk of the pharmacy benefit management industry. In this episode, Lucas and Luna unpack the economics of PBMs, the vertical integration wave, and a specific case: how firms like Madison Dearborn and Hellman & Friedman have rolled up multiple PBMs into a single giant. They walk through the 80-20 rule in drug pricing, the spread between what PBMs charge and what they pay pharmacies, and why regulators are starting to ask questions. If you've ever wondered why your prescription costs what it does, this episode explains the middleman…