PBMs' Influence on Drug Pricing and the Healthcare Economy
Episode description
In this episode of Healthcare Americana, host Christopher Habig interviews the VP of PBM Practice at Xevant, Shane Garduno, an expert in pharmacy benefit management (PBM). They discuss the role of PBMs in the healthcare industry and how they influence drug pricing. Shane explains that PBMs act as pharmacy insurance, handling coverage information, copays, deductibles, and prior authorizations. They also work with employers and health plans to control drug costs and implement cost-saving programs. PBMs negotiate discounts off the price of drugs and work with manufacturers to secure rebate dollars. Shane emphasizes the importance of transparency in PBM pricing and advises employers to negotiate for 100% of rebates and deeper discounts.
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