Sunday, the New York Times reported that drug companies, insurers, and pharmacies may “team up” to create effective monopolies. Company executives argue that this would be better for patients and would improve care and outcomes—however, nothing could be further than the truth. These conglomerates would further limit access and drive up costs.

Many patients and physicians have found frustration when attempting to prescribe a particular medication for a particular condition. Often only certain drugs are “on formulary” (which means they are on contract) at a particular institution. In the world of drug prices and availability, pharmacy benefit managers (or PBMs) serve as intermediaries between health plans, manufacturers, and pharmacies. PBMs are companies—such as Express Scripts, CVS CareMark, and others—that are hired by healthcare plans and tasked with determining what drugs are available in a certain plan and which covered patients have access. According to Forbes, Express Scripts, the leader in PBM market share, generated $101 billion in 2015.