Feb 5, 2020
Drugs are way too expensive. It has got to be from someone in the middle taking up all the money. Blame the pharmacy benefits managers! Right? Not so fast. If you're like me and have gotten derailed by complicated flow charts trying to understand PBMs in the past, this is the episode for you.
AJ Loiacono, CEO of Capital Rx, is a new PBM injecting some much-needed trust back into the system. By starting fresh and denouncing business as usual, AJ is giving control back to self-insured entities while looking after the community and specialty pharmacies that historically haven't had negotiating power. Don is joined by Shahid today and the tough questions are coming in hot! Enjoy!
If someone is being prescribed a $50,000 medication, my company makes $5. If someone's being prescribed a million dollar medication, my company makes $5. My competitor on a million dollar medication might make $200,000. That incentive is not aligned with both the patient care or the plan, and that's a problem. Personally, I think it should be completely against the law for any pharmacy benefit manager to be taking spread on drug and receiving payments from pharma industry.
There's a price to everything. Words and definitions and things to fight about and exclusions and going through a hundred-page contract, that is an artfully constructed pitfall.
A.J is a successful Entrepreneur and CEO of Capital Rx. He has over 20 years of experience in pharmacy benefits, finance, and software development. As the CEO of Capital Rx, his mission is to change the way pharmacy benefits are priced and administered in the US
Capital Rx is redefining the way prescriptions are priced and administered in the U.S. Through its Clearinghouse ModelSM, Capital Rx unlocks the pharmacy supply chain and reduces prescription costs for employer groups. By establishing a competitive marketplace for drug pricing, Capital Rx focuses its resources on deploying actionable strategies that improve plan performance and patient outcomes. The company’s commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America.