In this insightful conversation, Brad Hart, owner of Forest Park Pharmacy, exposes the hidden role of pharmacy benefit managers (PBMs) in inflating drug prices. He sheds light on the troubling vertical integration of healthcare, where insurers and PBMs profit at consumers' expense. Brad discusses the struggles independent pharmacies face, the impact of PBMs on Medicare costs, and exciting alternatives like compounding pharmacies. This episode is a wake-up call for anyone looking to understand the true cost of their medications and explore ways to save.
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insights INSIGHT
PBMs' Origin and Rise
Pharmacy benefit managers (PBMs) were created in the 1990s to manage drug coverage in employer health insurance.
The Affordable Care Act heightened PBM power, allowing them to negotiate rebates and control drug pricing.
insights INSIGHT
Vertical Integration Inflates Costs
Vertical integration means insurance companies own PBMs and pharmacies, like CVS owning Caremark and Aetna.
This setup leads to inflated drug prices and higher payments to their own pharmacies over independents.
insights INSIGHT
PBM-Controlled Mail Order Markups
PBMs own the mail order pharmacies and push doctors to send prescriptions there.
Mail order prices can be up to 10 times more expensive than independent pharmacies.
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EP. 215: I sat down with Brad Hart, owner of Forest Park Pharmacy in Fort Worth, to expose the shocking truth behind pharmacy benefit managers (PBMs) and how they’re driving up drug prices. What I learned about vertical integration in the healthcare system, where insurers own the PBMs and the pharmacies, honestly left me furious.
Brad breaks it all down, from Medicare waste to the skyrocketing cost of specialty drugs, and we talk about real solutions like compounding pharmacies and direct-to-consumer options. This is a must-listen if you’ve ever wondered why your medications cost so much—and who’s really profiting.
Topics Discussed:
What are pharmacy benefit managers (PBMs) and how do they increase drug prices?
How are health insurance companies profiting from vertical integration in the pharmacy system?
Why are independent and rural pharmacies struggling to stay open?
What impact do PBMs have on Medicare spending and prescription drug costs?
How can consumers save money on medications without relying on insurance?
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