By Mike McLain
The drug costs $133 a year at cash price. The JPMorgan plan paid $74,751…….1 employee. 1 generic drug. 12 fills.
Per fill, 30 tablets of teriflunomide:
→ Cash price, online pharmacy: $11.05
→ What the plan paid: $6,229.23
→ The gap: $6,218.18
That is the price alleged in Stern et al. v. JPMorgan Chase. The PBM was CVS Caremark.
In March 2026, a federal court let the case proceed and said it plainly: “The selection of a service provider is a fiduciary function.” The PBM is not the one being sued. The employer that selected it is.
Why that matters to you:
∞ If you are self-funded, the gap is your money… pure margin that you’ll never see. It leaves your account with every claim.
∞ Your employees pay it too, through premiums and cost sharing.
∞ You are the fiduciary. The PBM is not the one being sued.
CFOs and CHROs: how confident are you that this isn’t happening to your plan?
You can get in your car with your paper prescription, travel from one pharmacy to another asking the cost, and you will likely be amazed how much the price difference can be between stores. Or, you can present your nifty group plan pharmacy card you’ve always had and Greenback Health do that for you at the point of service in less time than you can say “What took so long!”