The "Patients Before Monopolies Act" aims to address significant conflicts of interest within the pharmaceutical supply chain by prohibiting common ownership between pharmacy benefit managers (PBMs) or insurance companies and pharmacies. This legislation seeks to restore competition and reduce prescription drug costs by preventing vertically integrated healthcare conglomerates from steering business to their own affiliated pharmacies. Such practices have been found to reduce competition, increase patient costs, and potentially allow companies to evade profit limits. Under this bill, any entity that directly or indirectly owns a pharmacy and also owns an insurance company or a PBM would be required to divest its pharmacy within one year of the Act's enactment. The Federal Trade Commission (FTC) and the Department of Justice (DOJ) are granted joint or separate jurisdiction to enforce these prohibitions. Non-compliance with divestment milestones could lead to monthly profit transfers into escrow and the appointment of a divestiture trustee. The bill also establishes robust enforcement mechanisms, allowing federal agencies, state attorneys general, and even private citizens to bring civil actions against violators. Individuals harmed by violations can seek relief including treble damages , attorney's fees, and other equitable remedies. Furthermore, courts can order violators to cease operations, divest pharmacies, and disgorge revenues received from prescription drug sales during the period of violation, with these funds directed to serve the health care needs of the harmed community.