Organized Money The PBM Hitman
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Jul 15, 2025 Antonio Ciaccia, President of 3 Axis Advisors and architect of Ohio’s Medicaid pharmacy overhaul, joins Benjamin Jolly, a pharmacist and advocate at the American Economic Liberties Project. They discuss Ohio's groundbreaking initiative to eliminate pharmacy benefit managers from Medicaid, saving $140 million in two years. Ciaccia reveals how he uncovered hidden costs in the pharmaceutical system, while Jolly shares insights into the benefits of this transparent model that’s gaining traction nationwide, despite the challenges facing independent pharmacies.
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Antonio Ciaccia's Unique Path
- Antonio Ciaccia failed organic chemistry but found his way into drug pricing advocacy.
- His unique background led him to uncover injustices in the PBM system in Ohio.
PBMs' Price Discrimination Power
- PBMs operate with a significant information advantage in drug pricing.
- Drug prices vary widely due to extreme price discrimination across actors and regions.
Managed Care Created Pricing Opacity
- Managed care privatized Medicaid drug purchasing creating a black box of pricing.
- This opacity enabled PBMs to invent prices and profit at the state's expense.