Unveiling the Hidden World of PBM Consulting with Trevor Daer, President & Founder at Granite Peak Analytics, LLC

Trevor Daer, President and Founder of Granite Peak Analytics, reveals the hidden complexities of Pharmacy Benefit Managers (PBMs) and why specialized consulting is crucial for self-funded health plans. He shares his journey from corporate burnout to creating a company that helps employers navigate the convoluted PBM landscape and avoid overpaying for prescription benefits.• PBM consulting helps benefits advisors navigate pharmacy complexity and secure better contracts for clients• Granite Peak Analytics was founded after discovering independent pharmacies were being squeezed by PBMs while employers overpaid• The pharmaceutical supply chain involves manufacturers, wholesalers (McKesson, Cardinal, AmeriSource Bergen), pharmacies, PBMs, and employers• "The Big Three" PBMs (Optum, Express Scripts, CVS Caremark) control 80-85% of the market and are vertically integrated with insurance carriers• PBMs have approximately 45 different revenue streams, creating misaligned incentives where they profit as drug costs increase• Employers without specialized PBM consulting typically overpay by up to 50% on their pharmacy benefits• Pharmacy costs have grown from 4-5% of self-funded plans to 25-30% today• Rebates create perverse incentives where higher-cost drugs are often preferred over lower-cost alternatives• Current trends include rising GLP-1 costs, specialty medications, and biosimilar adoption challenges• Active management of pharmacy benefits is essential, especially with expensive new therapies