Independent PBMs essentially worked to create consistency in drug pricing and to restrict drug manufacturers from overpricing — though some have also accused the PBMs themselves of causing drug price inflation. But now with this deal and the recent Aetna-CVS merger, that model is gone. And that means consumers could be worse off. “The PBM industry was born because this is a terrible idea,” said Pramod John, CEO of Vivio Health, a specialty drug management company. “We’re going backwards.”