Donald Trump's recent executive orders slashing drug prices and demanding transparency in pharmacy benefit manager fees are putting pressure on drug industry middlemen, according to Benzinga. Thomas Shipp of LPL Financial warned that domestic price-cutting pressures could erode pharmaceutical companies' pricing power and weigh heavily on their share prices by compressing margins. Shipp noted that PBMs are facing scrutiny for opaque pricing practices, including retaining manufacturer rebates and using "spread pricing" in drug distribution. CVS Caremark, Express Scripts, and OptumRx are the largest pharmacy benefit management companies in the U.S. Billionaire investor Mark Cuban called PBMs a “racket” on X, criticizing them for negotiating rebates instead of drug prices.