Imagine If There’s No PBMs – Its Easy If You Try

Once upon a time there was no such thing as a PBM…………………….

“I would believe we’re going to go to the marketplace where we don’t have rebates … because that will reduce pharmaceutical prices at the point of sale and very positively removing the 40 percent subsidy.”

If pharmaceutical companies do, indeed, have 40 points of margin to give up, as we have heard from other pharma CEOs, then someone isn’t telling the truth — CVS Caremark and Express Scripts claim they return 95 percent of the 40 percent subsidy back to the employers and their members.

Unfortunately, it’s impossible today to tell where the double-talk is coming from. Making rebates obsolete would give us the answer and keep everyone honest.


We just finished a large manufacturing renewal involving a DPC where we cut costs on the generic costs by 60%…on track to save the plan and the employees $240K combined… example  $29 scripts at CVS  $5 copay and $24 bill from the pharmacy….for a 30 day supply the DPC dispensed that med for $0.90….3200% markup from CVS….

DPC hired a full time pharma tech….now stocks 300+ standard meds (no controlled sustances)….about 50% are delivered at no cost (employer agreed to a $10 PEPM increase from $50 – $60 to cover an additional 150 meds and behavioral health for 800 lives)….DPC practice is at 1400 lives….up from 400….