EP465: The Not Super Effective Contracting Industry Norm, Where Jumbo Plans and Others Wind Up Paying $10,000 for $50 Drugs, With Chris Crawford

Feb 27, 2025

Chris Crawford, CEO of RxSaveCard, dives into the murky waters of pharmacy benefits and inflated drug prices. He shines a spotlight on the hidden costs imposed by large Pharmacy Benefit Managers (PBMs) and discusses a significant lawsuit involving J&J. Crawford explains how aggregate discount guarantees often lead to higher prices for consumers, while cash-pay options can offer real savings. The conversation encourages transparency in drug pricing and highlights innovative tools that help both employers and employees navigate the complex pharmaceutical landscape.

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Intro

00:00 • 5min

Unpacking the PBM Pricing Dilemma: Generic Drugs and Consumer Costs

04:37 • 3min

Unpacking PBM Contracts and Drug Pricing

07:52 • 12min

Navigating Transparency and Cost in Pharmacy Benefits

20:21 • 4min

The Impact of Competition on Drug Pricing

23:57 • 8min

Navigating the Emerging Cash Marketplace in Pharmaceuticals

32:08 • 2min

The Hidden Costs of PBMs: How Aggregate Discount Guarantees Inflate Drug Prices. In episode 465 of Relentlessly Seeking Value, host Stacey Richter interviews Chris Crawford, CEO of RxSaveCard, about the inflated costs within the pharmacy benefits industry.

The discussion centers around a lawsuit involving J&J, highlighting how large PBMs can significantly overcharge for drugs that are available much cheaper through cash-pay options like Mark Cuban's Cost Plus Drugs.

Crawford explains how Aggregate Discount Guarantees, a common contracting mechanism, often fail to control spread pricing effectively and instead may lead to higher costs for plan sponsors and employees. The episode also covers how RxSaveCard can help employers and employees access these lower cash prices, circumventing the inflated costs from traditional PBMs.

=== LINKS ===

🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP465

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07:17 EP397 with Paul Holmes.

07:19 EP439 with Luke Slindee, PharmD.

07:20 EP379 with AJ Loiacono.

07:44 What is the Aggregate Discount Guarantee?

13:49 Why do the divergent list prices and the perverse incentives prevent the Aggregate Discount Guarantee from really limiting cost spread?

17:55 Why is it important for plan sponsors to check these drug cost prices, and how can employers check them?

23:56 What drives cost lower, and why does it change everything?

25:09 How does RxSaveCard work?

25:44 EP461 with Chris Crawford.

30:01 Do you need a PBM’s permission to use RxSaveCard?

30:37 How does it look for employers/employees to use the RxSaveCard?

32:39 EP356 with Ge Bai, PhD, CPA.