S4, Ep 10- PBM Practices Uncovered: A Closer Look at Drug Pricing

Dr. Robert Popovian and Conner Mertens dive into the problematic practices of Pharmacy Benefit Managers (PBMs) that prioritize profits over patient access to affordable medications. Focusing on the case of a generic asthma medication offered at a discount yet overlooked by PBMs, the hosts explore the deep-seated issues of misaligned incentives in health care. They also discuss innovative solutions to bypass the traditional pharmaceutical distribution system, aiming to enhance patient access and affordability. Join our hosts as they explore the complexities of health care economics and the path towards a more equitable system. Among the highlights in this episode: 02:21: Our hosts discuss the problematic practices of PBMs, such as refusing to cover cheaper, generic medications for profit motives 03:08: Dr. Popovian explains how rebate systems influence PBMs to prefer higher-priced brand-name drugs over generics, leading to misaligned incentives that do not favor cost savings for patients or employers 04:36: Our hosts touch upon how PBMs exclude drugs from formularies, not for efficacy reasons but for profit, impacting patient access and savings negatively 05:49: Dr. Popovian speaks on the potential benefits of pharmaceutical companies selling directly to consumers, bypassing PBMs and insurers, and how it could save patients money and increase access 10:01: Our hosts discuss how direct-to-consumer sales, and other models like direct sales to health providers or employers, could challenge the current pharmaceutical distribution system dominated by PBMs 13:09: Dr. Popovian and Conner discuss the importance of seeking ways to make health care more accessible and affordable 14:27: Conner shares his thanks and reflections as he says goodbye to the series Contact Our Hosts Dr. Robert Popovian, Chief Science Policy Officer at GHLF: [email protected] Conner Mertens, Patient Advocate and Community Outreach Manager at GHLF: [email protected] A podcast episode produced by Ben Blanc, Associate Director, Digital Production and Engagement at GHLF. We want to hear what you think. Send your comments, or a video or audio clip of yourself, to [email protected] Listen to all episodes of Healthcare Matters on our website or on your favorite podcast channel.See omnystudio.com/listener for privacy information.