The Federal Trade Commission accused UnitedHealth's OptumRx, CVS Caremark, and Cigna's Express Scripts of pocketing over $7 billion in markups on generic specialty drugs over a 5-year period. The Big Three PBMs drastically marked up specialty generic drug prices at affiliated pharmacies, with increases ranging from hundreds to thousands of percent. Brian Thompson's accused killer, Luigi Mangione, claimed industry failures as his motive. Under Thompson, denied claims at twice the industry average.