Decoding Drug Pricing in America with RxBenefits

In this episode of Healthcare Happy Hour, sponsored by RxBenefits, host David Saltzman speaks with KC Armstrong, director of business development at RxBenefits, about the evolution of the pharmacy industry, the complexities of drug pricing in the U.S., and strategies for self-funded plans. KC shares insights on how RxBenefits has adapted to the rapidly changing landscape of healthcare and pharmacy, the role of Pharmacy Benefit Managers (PBMs), and the various factors influencing medication costs. The discussion also highlights the importance of data-driven strategies for employers looking to manage their pharmacy spend effectively.

Takeaways

• RxBenefits started as a customer service organization in 1995.
• The pharmacy landscape has evolved significantly over the years.
• Self-funding opens up more options for employer groups.
• Drug prices have skyrocketed, with some medications costing thousands per month.
• The role of PBMs is crucial but often misunderstood.
• There are many influencers behind the scenes affecting drug pricing.
• Healthcare entities operate with profit motives, even nonprofits.
• The U.S. has a unique free market approach to drug pricing.
• Not all new medications are better or more effective than existing ones.
• Data-driven insights are essential for managing pharmacy benefits.
  

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