The Trump administration can’t decide whether drug industry middlemen are the enemy — or part of the solution

WASHINGTON — Some days, President Trump vows to eliminate them.

But then, there are days when his top health lieutenants promise to empower them. There are even days when they do both.

The mixed and muddled signals from the administration are over the increasingly contentious role of the pharmacy benefit managers, or PBMs. Those discordant signals reflect a lack of clarity from Trump and his lieutenants over how best to address one of their top priorities: how to lower prescription drug prices.

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