A recent Gallup poll found that a whopping 18 million Americans"including 20 percent of Americans who make less than $24,000 annually"cannot afford at least one of their prescriptions. The status quo is sad and tragic and needs to end. Congress can help by addressing seemingly monopolistic forces in the industry that may be keeping costs high. Congress should start by investigating the potential anti-competitive activities posed by the nation's leading drug wholesalers. The nation's three largest pharmaceutical distributors own an estimated 75 percent of the nation's pharmacy services administrative organizations (PSAOs)"the organizations that are supposed to negotiate good drug contract deals on pharmacies' behalf. If the major companies that sell drugs owning the entities that are supposed to restrain drug prices sounds like a clear conflict of interest, that's because it probably is one. And the fact that these three pharma distributors have already been the subject of nationwide Department of Justice and Federal Trade Commission lawsuits for seemingly predatory business activities only compounds this alarming antitrust issue. A growing number of states"including Louisiana, Maryland, and Wisconsin"have begun investigating the role that PSAOs may play in America's drug price-gouging problem and have passed legislation to increase PSAO transparency and oversight. That said, this is a federal issue and requires a federal solution.