Big health insurers have found yet another new way to extort customers — by buying up “pharmacy benefit managers,” (companies that supply medications to people) and then forcing subscribers to buy medications exclusively from the drug distributors they own. People are receiving letters from their health insurance companies telling them they must either buy medications from a specific company they own and get medications through the mail, or patronize a retail drug store of their choice and pay a much higher price. Prices may be lower for insurance companies under this kind of arrangement, but policyholders miss out on face-to-face interaction with pharmacists, who verbally counsel customers on drug dosing instructions and dangerous interactions with other drugs. Herding people towards a single option drug supplier is also taking a toll on neighborhood pharmacies who have been serving the same families for generations. The trend towards consolidation in the drug sales market starkly limits consumer choice. Just three major pharmacy benefit management companies dominate the drug delivery market: Express Scripts Holding, which recently bought Medco for $29 billion, CVS Caremark, and OptumRX, a subsidiary that now belongs to the big health insurance company UnitedHealthcare Group.