Podcasts about pbms

"I doubled my profit when I lost 70% of my customers, which is insane." - Brad HartMy guest this week, Brad Hart, owner of Forest Park Pharmacy, came on the show to discuss how he moved his pharmacy from struggling to survive in a broken, insurance-based reimbursement model to thriving as an all-cash, "cost-plus" business.Brad popped on my radar because of his very popular and informative Instagram profile, where he shows how everyday Americans are getting fleeced by PBMs. We break down the mechanics of his model and discuss the "low copay trap," why the term "specialty generic" is nonsense, and how his pharmacy's Price Checker tool brings radical transparency to a purposefully confusing industry.We also dive into the exponential overpayments Brad has uncovered in the Medicare system, where a drug that costs his pharmacy $96 is reimbursed for over $3,400.This is one you won't want to miss!Chapters:(00:00:00) This Pharmacy Went Cash-Only, Lost 70% Of Customers, & Doubled Profits(00:07:28) The "Cost-Plus" Pharmacy Model, Explained (00:08:49) How Brad Lost 70% of Customers & Doubled Profits (00:10:45) The Deceptive "Low Copay Trap" (00:13:29) The Pricing Breakdown: Cost + 15% + $10 (00:34:52) Why the Term "Specialty Generic" is Nonsense (00:47:53) What is the Average Wholesale Price (AWP)? (00:52:41) PBM Reform vs. Direct-to-ConsumerKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"I doubled my profit when I lost 70% of my customers, which is insane." - Brad HartMy guest this week, Brad Hart, owner of Forest Park Pharmacy, came on the show to discuss how he moved his pharmacy from struggling to survive in a broken, insurance-based reimbursement model to thriving as an all-cash, "cost-plus" business.Brad popped on my radar because of his very popular and informative Instagram profile, where he shows how everyday Americans are getting fleeced by PBMs. We break down the mechanics of his model and discuss the "low copay trap," why the term "specialty generic" is nonsense, and how his pharmacy's Price Checker tool brings radical transparency to a purposefully confusing industry.We also dive into the exponential overpayments Brad has uncovered in the Medicare system, where a drug that costs his pharmacy $96 is reimbursed for over $3,400.This is one you won't want to miss!Chapters:(00:00:00) This Pharmacy Went Cash-Only, Lost 70% Of Customers, & Doubled Profits(00:07:28) The "Cost-Plus" Pharmacy Model, Explained (00:08:49) How Brad Lost 70% of Customers & Doubled Profits (00:10:45) The Deceptive "Low Copay Trap" (00:13:29) The Pricing Breakdown: Cost + 15% + $10 (00:34:52) Why the Term "Specialty Generic" is Nonsense (00:47:53) What is the Average Wholesale Price (AWP)? (00:52:41) PBM Reform vs. Direct-to-ConsumerKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

Why do drugs like Ozempic cost $1500 in the U.S., but only $147 in Canada? Most people don't know about the invisible middleman making more than 10 of the top drug companies combined.Healthcare may seem like a broken system, but it's actually not broken at all. It works great; it's just not working for you. Pharmacy benefit managers use their contracts to make massive profits off of everyone.PBMs may appear to be helpful. They negotiate lower prices for manufacturing companies, reduce out-of-pocket expenses, and handle logistics between employers and insurance companies. Pharmacy benefit managers charge the employer a very high price and pay the pharmacies a very low price, pocketing the difference. This is known as spread pricing. PBMs decide which drugs your plan covers, how much you'll pay out of pocket, which pharmacy you can use, and when or if you'll get your medication.Cheaper and better drugs are often denied if PBMs don't get a big enough rebate. They can even force you to fill your prescriptions at specific PBM pharmacies for more profit.Drug companies have to give PBMs a kickback or “rebate” to get their drugs covered by insurance companies. To afford this rebate, drug companies raise the list price, and PBMs promote the drug that gives them the most profit.Pharmacy benefit managers own insurance companies and pharmacies. Three of the largest PBMs control 80% of the medications in the U.S. Surprisingly, PBMs don't exist in other countries. Dr. Eric Berg DC Bio:Dr. Berg, age 60, is a chiropractor who specializes in Healthy Ketosis & Intermittent Fasting. He is the author of the best-selling book The Healthy Keto Plan, and is the Director of Dr. Berg Nutritionals. He no longer practices, but focuses on health education through social media.

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: FDA approves the first fast-acting biosimilar insulin in the US, Tandem issues warning, DOJ stands up for remote monitoring in schools, GLP1 use protects against dementia, and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom   Check out VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX We've got the first and only biosimilar FDA approved and moving to market. Kirsty – insulin aspart, which is a biosimilar to Novolog will be available as a single-patient-use prefilled pen for subcutaneous use and a multiple-dose vial for subcutaneous and intravenous use. KIRSTY has been available in Europe and Canada since 2022. This same company makes Semglee, the first biosimilar for long acting? Sales of Insulin Aspart in the United States were approximately $1.9 billion in 2024, according to IQVIA. https://www.globenewswire.com/news-release/2025/07/15/3115973/0/en/Biocon-Biologics-Expands-Diabetes-Portfolio-with-FDA-Approval-of-Kirsty-the-First-and-Only-Interchangeable-Rapid-Acting-Insulin-Aspart-in-the-United-States.html XX Tandem Diabetes Care (Nasdaq:TNDM) has issued an urgent medical device correction for some t:slim X2 automated insulin pumps. In a July 22 notice, the San Diego-based company warned of pumps that may exhibit a higher rate of speaker failure. During normal use, the insulin pump software monitors current flowing through the speaker during use. Measurements that fall within a pre-determined range indicate a functioning speaker. Meanwhile, measurements falling outside the range indicate a speaker failure.   When the measurements land outside the expected range, the system declares a malfunction, referred to as “Malfunction 16.” If the pump declares this malfunction, insulin delivery will stop and the pump will no longer be operational. Malfunction 16 terminates communication between the pump and continuous glucose monitor (CGM), as well as the t:slim mobile app.   If not addressed, the issue can lead to hyperglycemia, which can result in hospitalization or medical intervention. The company reports 700 adverse events and 59 reported injuries to date, with no reports of death.   Tandem identified that certain speaker versions have a higher rate of Malfunction 16 events due to a wiring issue within the speaker. Users can continue using their pump but with added precautions because Malfunction 16 can occur at any time. They should use the t:slim mobile app with push notifications turned on so the app alerts them if the malfunction occurs, the company said.   Additionally, Tandem intends to release a software update aimed at enhancing the early detection of speaker failure. The update also introduces persistent vibration alarms to help reduce potential safety risk. Tandem plans to notify affected pump users when it makes the update available. https://www.drugdeliverybusiness.com/tandem-warns-insulin-pump-speaker-malfunction/ XX BIG WIN! The DOJ protects T1D rights again! The US Attorney's office for the Western District of Washington State reached a settlement with a public school district that once again confirms remotely monitoring students' CGMs is a reasonable accommodation that schools must provide to comply with the Americans with Disabilities Act. If its true for one state its true for all states under federal law! If your local schools still refuse to remotely monitor CGMs of their students, provide them with this letter to compel them to FOLLOWT1Ds and FOLLOW Federal Laws. If they still refuse contact us! https://followt1ds.org/ XX new study finds people taking GLP-1 agonists had a significantly lower cumulative risk of developing dementia, when compared to metformin users. Past studies show that people who have type 2 diabetes — a chronic condition where the body does not use its insulin properly — are at a higher risk of developing dementia. The study found that when comparing the neuroprotective abilities of two diabetes medications — metformin and glucagon-like peptide-1 receptor agonists (GLP-1 agonists) — participants taking GLP-1 agonists had a significantly lower cumulative risk of developing dementia, when compared to metformin.   https://www.medicalnewstoday.com/articles/glp-1s-may-offer-better-dementia-protection-than-metformin XX Front office changes coming to Dexcom.  CEO Kevin Sayer will step down  & give the reins to current Chief Operating Officer Jake Leach. Scheduled for January 1, 2026, Leach will also join Dexcom's board of directors where Sayer will remain  executive chairman. One of our frequent guests here.. Leach has worked at Dexcom for 21 years. He served as chief technology officer from 2018 to 2022 before he was named COO in late 2022. He was given the title of president in May. https://www.medtechdive.com/news/dexcom-ceo-change-kevin-sayer-jake-leach/756382/ XX A major international study has revealed that many children and young adults in Sub-Saharan Africa who are diagnosed with type 1 diabetes (T1D) may actually have a different, non-immune-based form of the condition. Unlike the traditional autoimmune version of T1D, this form appears to develop without the immune system attacking the insulin-producing cells. This finding could significantly reshape how diabetes is diagnosed and treated across the region, potentially leading to more precise care and better health outcomes. The researchers found that many young people in Sub-Saharan Africa diagnosed with T1D often don't have the usual markers in their blood (called islet autoantibodies) typically seen in people with T1D in other parts of the world. Specifically, 65% of participants with T1D in this region did not have islet autoantibodies. When the researchers compared this data to studies in the U.S., they found a smaller but significant proportion (15%) of Black participants diagnosed with T1D had a similar form of diabetes found in Sub-Saharan Africa – characterized by negative autoantibodies and a low T1D genetic risk score.   However, white Americans with T1D showed the typical autoimmune pattern, even if they didn't have detectable autoantibodies, their genetics still pointed to autoimmune diabetes.   “The identification of this T1D diabetes subtype in Sub-Saharan African populations and among individuals of African ancestry in the U.S. suggests a potential ancestral or genetic link,” Dabelea notes. “These findings highlight the need to consider alternative etiologies in this group and a deeper understanding of the underlying mechanisms may provide important insights for future prevention and treatment strategies.”     https://scitechdaily.com/new-diabetes-subtype-discovered-in-africa-challenges-global-assumptions/   XX Formal recognition for the specialty of Diabetology.   Diabetology is the specialty focused on the full continuum of diabetes care — encompassing diagnosis, treatment, prevention, technology integration, education, and cardiometabolic management. While it intersects with endocrinology, primary care, and public health, diabetology is uniquely defined by its depth and focus on diabetes alone.       The American College of Diabetology (ACD) is the national professional organization representing clinicians who specialize in diabetes care. ACD advances clinical excellence and education to improve the lives of those affected by diabetes. https://www.businesswire.com/news/home/20250725766248/en/American-College-of-Diabetology-Announces-Formal-Taxonomy-Classification-for-Diabetology   XX Tidepool announces cloud-to-cloud integration with Abbott's FreeStyle Libre portfolio. From the release: This integration allows people living with diabetes using the FreeStyle Libre portfolio to connect their data to their Tidepool account seamlessly. For healthcare providers, this means more comprehensive insights and streamlined workflows, with FreeStyle Libre systems data flowing continuously into the Tidepool Data Platform. https://www.tidepool.org/blog/abbott-freestyle-libre-integration-launched XX Stelo dexom ai food XX With high drug prices remaining an ongoing concern for U.S. politicians, Roche is considering following in the footsteps of some of its peers with a direct-to-consumer (DTC) model to cut out the middlemen.     About 50% of the money spent on drugs in the U.S. healthcare system goes straight to PBMs instead of the companies that create the medicines, Roche CEO Thomas Schinecker called out in a press conference on Thursday.   Bringing the drugs directly to the consumer could be a solution to positively impact pricing for patients “without destroying innovation,” Schinecker added on a separate Thursday call with investors, noting that the company has discussed the matter with the U.S. government and its Department of Health and Human Services. The pricing talks come after President Donald Trump inked a “Most Favored Nation” executive order in May, aiming to tie U.S. drug prices to lower prices in other developed nations. The plan was quickly called out by industry voices such as the PhRMA trade group, which labeled it a “bad deal” for U.S. patients. https://www.fiercepharma.com/pharma/roche-weighing-direct-consumer-drug-sales-ease-us-drug-pricing-woes-cut-out-pbms-ceo-says XX SAB BIO secures substantial $175M financing to advance T1D therapy with impressive investor lineup and extended cash runway until 2028. Most critically, this financing fully funds the pivotal Phase 2b SAFEGUARD study evaluating SAB-142 for delaying progression of autoimmune Type 1 diabetes in newly diagnosed patients. By extending the cash runway into mid-2028, SAB has effectively eliminated near-term financing risk and provided clear visibility through this crucial clinical trial and potential commercialization preparation. Participation from strategic investor Sanofi, along with new investors RA Capital Management, Commodore Capital, Vivo Capital, Blackstone Multi-Asset Investing, Spruce Street Capital, Forge Life Science Partners and Woodline Partners LP, and existing investors Sessa Capital, the T1D Fund, and ATW Partners         https://www.stocktitan.net/news/SABS/sab-bio-announces-oversubscribed-175-million-private-fwsf2t91ek4z.html   XX In a landmark 14-year study, researchers have found that artificially sweetened drinks raise the risk of developing type 2 diabetes by more than a third, significantly higher than those loaded with sugar. It challenges the long-standing perception of diet drinks being a healthier alternative and suggests they may carry metabolic risks of their own. In the first longitudinal study of its kind, led by Monash University, researchers tracked 36,608 participants over an average period of 13.9 years to assess how both sugar-sweetened beverages (SSBs) and artificially sweetened beverages (ASBs) impacted health outcomes. The self-reported health data, from the Melbourne Collaborative Cohort Study, was drawn from participants aged 40 to 69 years at the time of recruitment.   What they found was that drinking just one can of artificially sweetened soda increased the risk of developing type 2 diabetes by 38%, compared to people who didn't consume these drinks at all. For those consuming the same amount of sugary drinks, the risk was 23% higher. This suggests there's more than obesity at play. The researchers believe this result is due to an independent metabolic effect, possibly gut microbiome disruption or a change in glucose metabolism.   While the study didn't identify which artificial sweeteners were at play,   Evidence suggests that artificial sweeteners can alter the composition and function of gut bacteria, leading to glucose intolerance – a precursor to type 2 diabetes. And that some sweeteners may trigger insulin release, desensitize metabolic responses over time, or confuse the body's glucose regulation system – even without actual sugar in the picture.   Another hypothesis is that regular exposure to the kind of intense sweetness that artificial products deliver may condition the body to anticipate sugar calories that never come, affecting appetite regulation, insulin sensitivity and broader metabolic pathways. However, the authors suggest that how sweeteners affect the gut microbiota and glucose regulation are the most likely drivers of increased diabetes risk.   https://newatlas.com/diet-nutrition/one-drink-diabetes-risk/ XX After months of deliberation, information gathering and public testimony, a state board unanimously agreed Monday that two common medications for type-2 diabetes and other conditions appear to pose an affordability challenge to the state and Marylanders.   The state Prescription Drug Affordability Board approved two resolutions saying that prescription drugs Jardiance and Farxiga likely pose an “an affordability challenge for the state health care system” and the state should look for ways to bring down those costs.   Health care advocates call the long-awaited resolution an “important first step” in the process in bringing down prescription costs for those on the state's health plan.       That milestone has been years in the making. Created in 2019 by the General Assembly, the Prescription Drug Affordability Board was slow to launch due in part to a veto from former Gov. Larry Hogan (R) amid pandemic-induced economic uncertainty in 2020 that delayed the board's formation. The board also cited out-of-pocket costs for consumers and state and local spending on those drugs as indicators that there may be an affordability challenge.   The board will now look at options to address the potential affordability challenge, which could include setting an upper payment limit on those drugs. But it's not clear when the state will see cost savings.   That said, some members of the health care system and the pharmaceutical industry say that policies such as upper payment limits could weaken access to life-saving drugs. Others say that the board has not engaged enough viewpoints from the health care industry. https://marylandmatters.org/2025/07/29/state-board-determines-two-type-2-diabetes-drugs-may-be-unaffordable/   XX One year after it was revealed that Chrissy Teigen and John Legend's son, Miles, was diagnosed with type 1 diabetes, Teigen is revealing how she's making her son feel more included. Teigen first opened up about her 7-year-old son's diagnosis after she and her two oldest kids, Miles and 9-year-old daughter Luna were at the 2024 summer Olympics cheering on Simone Biles. Teigen posted a photo of Miles and Luna holding up a sign. Also visible in the picture was the insulin pump on Miles' arm. Now, Teigen is sharing some insight into how she's making Miles more comfortable with having type 1 diabetes, including giving LeBron James' Barbie doll type 1 diabetes as well. In a video shared on Instagram, Teigen is seen taking the T1D Barbie, removing her insulin pump and gluing the pump onto LeBron James' Barbie. “Turning T1D Barbie into T1D Lebron James for my son,” Teigen captioned the video, revealing James is Miles' hero. 41 million followers https://www.yahoo.com/lifestyle/articles/chrissy-teigen-gives-lebron-james-154608782.html  

Elliot Cohen—PillPack co-founder and now co-founder of General Medicine—joins Jacob Effron and Nikhil (Out-of-Pocket) to unpack what “best care” really means in 2025. He explains why General Medicine is building a broad front door to care. Elliot also revisits the PillPack vs. PBMs saga, what Amazon Pharmacy got right (and what was unexpectedly hard), and how AI is already raising the bar in intake, clinical prep, and follow-up. (0:00) Intro(0:58) Simplifying Healthcare with General Medicine(1:53) The Importance of Triage in Healthcare(3:22) Consumer Empowerment in Healthcare(5:10) Patient Experience and Structured Forms(6:27) Challenges in Healthcare Pricing Transparency(8:28) Diverse Patient Needs and Quality of Care(10:00) The Philosophy Behind General Medicine(16:43) Consumer Directed Care: Pros and Cons(18:57) PillPack(35:53) Debating Insulin Search Results(38:16) AI in Healthcare: A New Era(39:15) Integrating AI with Clinical Teams(41:39) Challenges and Opportunities in Digital Therapeutics(58:21) Building a Healthcare Company: Lessons from Amazon(1:01:25) Quickfire Out-Of-Pocket: https://www.outofpocket.health/

Are PBMs stealing your profits? In this

On episode 244, Lynnsey and Matthew are joined by Ray Waldrup, Co-Founder and CEO of The Leaders Rheum, a national network of leading rheumatology practices. Drawing on 3 decades of experience in healthcare leadership, Ray shares his insights on the challenges and opportunities facing independent physician practices today. From the impact of hospital and private equity ownership to the growing influence of insurance companies and PBMs, Ray offers an inside look at the forces reshaping the healthcare landscape. We also dive into how The Leaders Rheum supports independent practices through aggregation, management services, and industry expertise. Tune in for a conversation on the future of independent care!

The show discussions are Modern Medical Mafia and Patient Protector - two projects to help expose PBMs. We discussed ways independent pharmacy owners can get involved in local legislation and patient education about PBMs and how they impact pharmacies. 

What happens when patients can't afford the medicine you've worked so hard to create? In this episode, host Elaine Hamm, PhD, sits down with Vinay Patel, PharmD—Chief Pharmacy Officer at Proactive MD and Founder of MakoRx—to unpack the hidden complexities behind drug pricing, access, and affordability. Together, they explore how traditional insurance models impact patient care, and what drug developers and startups need to know to ensure their therapeutics actually reach the people who need them. In this episode, you'll discover: Why pharmacy benefit managers (PBMs) influence drug access—and what that means for your commercialization strategy. How cost-plus pricing models are changing the healthcare landscape. Key considerations for biotech innovators to ensure affordability, patient access, and long-term success. Whether you're developing a new therapeutic or trying to understand the real-world implications of drug pricing, this conversation offers a powerful look behind the pharmacy counter. Links: Connect with Vinay Patel, PharmD, and check out Proactive MD and MakoRx. Connect with Elaine Hamm, PhD, and learn about Tulane Medicine Business Development and the School of Medicine. Learn more about The Study, Elaine's wine bar. Connect with Ian McLachlan, BIO from the BAYOU producer. Check out BIO on the BAYOU and make plans to attend October 28 & 29, 2025. Learn more about BIO from the BAYOU - the podcast. Bio from the Bayou is a podcast that explores biotech innovation, business development, and healthcare outcomes in New Orleans & The Gulf South, connecting biotech companies, investors, and key opinion leaders to advance medicine, technology, and startup opportunities in the region.

In this episode of MedNation, Dr. David Farnin interviews Dr. Vinay Patel, a pharmacist and the founder of Makorx, who is on a mission to transform the pharmacy industry. Dr. Patel highlights the significant issues with pharmacy benefit managers (PBMs), which control drug prices and access. He explains Makorx's innovative cost-plus pricing model, which promotes transparency and affordability. With over 20,000 participating pharmacies, Makorx challenges the conventional pharmacy landscape, focusing on empowering patients and reducing costs. Dr. Patel shares his journey from a conventional pharmacist to a health industry innovator aiming to improve drug accessibility nationwide.Cutting Edge Foot and Ankle: Website: https://cefootandankle.com/ Instagram: @cefootandankle

At ACCESS US 2025, our live podcast The Future of Access features four experts exploring how to improve drug affordability and access while maintaining innovation. With rising drug costs, we ask: What bold models are emerging? We cover benefit design, PBMs, AI, evolving pharmacy models, and whether markets can act before regulation. Conference Overview Sarah Emond – ICER John O'Brien – National Pharmaceutical Council Annette Powers – Bristol Myers Squibb Ray Pressburger – Accenture Stuart Altman – Power, Politics and Universal Health Care PBMs 340B Program Copay Maximizers Net Price Lilly Direct Indolent Disease, PFS Concomitant Drug HIV & AZT Orphan Drugs Calquence vs Imbruvica Value-Based Contracts Outcome-Based Contracts Disruptive PBMs CostPlus Drugs Fair Access 2024 Drug Rebates Drug Carve-Outs Dynamic Pricing Accelerated Approvals ICER Assessment Questions? Email comments@prescriptionforbetteraccess.com. Follow us on X, LinkedIn, YouTube, and Threads.

What happens when a board-certified OB-GYN starts questioning everything she was taught? In this episode of Medical Disruptors, I sit down with Dr. Suzanne, a conventionally trained physician who nearly walked away from medicine altogether—until she realized the problem wasn't her. It was the system. And the ones impacted the most? Mid-life women searching for answers. In this episode, we talk about why so many midlife women are being ignored, misdiagnosed, or flat-out dismissed. As Dr. Suzanne puts it, “Tell me you don't like older women without telling me you don't like older women.” We talk about what it means to blend surgical precision with Ayurvedic wisdom, how integrative medicine started as a whisper behind closed doors. Dr. Suzanne opens up about the fear of being labeled “quacky,” the burnout of practicing within insurance constraints, and the radical act of slowing down enough to listen.  We also dig into the structural mess—PBMs, prior authorizations, and why clinicians and patients are both suffering.  But this conversation isn't just about what's broken. It's about what's possible. It's about women reclaiming agency in midlife and clinicians rebuilding medicine on their own terms. This one's for anyone who's tired of being dismissed, miscategorized, or left behind.  Come for the hormone talk.  Stay for the revolution. Learn more about your ad choices. Visit megaphone.fm/adchoices

GDP Script/ Top Stories for July 12th Publish Date: July 12th PRE-ROLL: From the BG AD Group Studio Welcome to the Gwinnett Daily Post Podcast. Today is Saturday, July 12th and Happy Birthday to Christine McVie I’m Peyton Spurlock and here are your top stories presented by Gwinnett KIA Mall of Georgia. Gwinnett charges dropped against detained journalist Mario Guevara Georgia Power to update energy forecasts amid uncertain demand Lawmakers conclude listening tour on access to cancer care All of this and more is coming up on the Gwinnett Daily Post podcast, and if you are looking for community news, we encourage you to listen daily and subscribe! Break 1: 07.14.22 KIA MOG STORY 1: Gwinnett charges dropped against detained journalist Mario Guevara Local journalist Mario Guevara, known for covering Atlanta's Hispanic community and ICE operations, is no longer facing traffic charges in Gwinnett County. Solicitor General Lisamarie Bristol announced insufficient evidence to prosecute charges of reckless driving, unlawful use of a telecommunication device, and failure to obey signs, as the incidents occurred on private property. However, Guevara still faces federal immigration charges, with ICE questioning his legal status despite his work permit and ongoing efforts toward permanent residency. Guevara claims he is being targeted for his journalism, which has drawn local and national attention. STORY 2: Georgia Power to update energy forecasts amid uncertain demand Georgia Power's 2025 Integrated Resource Plan (IRP) faces scrutiny for overestimating energy demand, driven by the rapid growth of data centers. Critics, including environmental groups, argue the projections could leave ratepayers covering billions in stranded assets if demand falls short. While Georgia Power committed to updating forecasts and reporting on large-load projects, many called for stronger demand-side management (DSM) efforts to reduce energy needs. The utility plans to increase DSM spending from $90M to $160M annually, but some remain dissatisfied. The PSC will vote next week, with debates ongoing over coal plant operations and natural gas upgrades. STORY 3: Lawmakers conclude listening tour on access to cancer care Around 66,000 Georgians will be diagnosed with cancer this year, with 19,000 deaths expected, prompting state lawmakers to study ways to reduce these rates. Georgia exceeds national averages for lung, prostate, breast, and colorectal cancer, with rural areas facing significant barriers to care due to rising costs, limited access, and medical industry consolidation. Experts highlighted issues like pharmacy benefit managers (PBMs) controlling drug markets and low reimbursement rates for clinics. Lawmakers aim to address drug pricing, access to screenings, and systemic healthcare challenges, with plans to continue studying cancer care access and solutions. We have opportunities for sponsors to get great engagement on these shows. Call 770.874.3200 for more info. We’ll be right back Break 2: STORY 4: Deputies: Buford man threw deep freezer at 59-year-old at Lake Lanier after fight over nudity A Buford man, Logan Nicholas Young, 42, was arrested on July 3 after a bizarre incident on Lake Lanier involving public indecency, a fight, and a flying deep freezer. Young allegedly got naked on a boat, argued with a 59-year-old man, punched him, and later threw a deep freezer at him, causing a head injury and knocking him into the lake. Deputies found Young hiding under a bed on his houseboat after he ignored their attempts to contact him. He was charged with six offenses, including aggravated assault, and released on bond on July 6. STORY 5: Robert Michener named Gateway85 CID's interim executive director The Gateway85 Community Improvement District (CID) appointed longtime employee Robert Michener as interim executive director following Emory Morsberger's resignation after nearly 20 years of involvement. Michener, with 17 years at Gateway85, previously served as director of operations, overseeing infrastructure, security, and landscaping projects. Board Chairman Shiv Aggarwal praised Morsberger's contributions and welcomed Michener's leadership during the transition. The CID will continue focusing on economic development, mobility, and quality of life improvements as it searches for a permanent leader. Michener expressed excitement about guiding the district's next phase of growth. Break 3: STORY 6: 'Superman' stars excited to bring DC reboot to theaters Edi Gathegi, Isabela Merced, and Anthony Carrigan star in the new "Superman" reboot, with Gathegi playing Mr. Terrific, Merced as Hawkgirl, and Carrigan debuting as Metamorpho. At a red carpet event in Atlanta, Gathegi contrasted his survival as Mr. Terrific with his infamous death as Darwin in "X-Men: First Class." Merced highlighted the mix of CGI and practical sets, comparing her Hawkgirl role to her experience in "Dora the Explorer." Carrigan, excited to bring fan-favorite Metamorpho to life, praised the detailed makeup used instead of CGI. STORY 7: Gwinnett fire investigators say arsonist tried to burn down Lawrenceville home Gwinnett County fire officials are investigating a suspected arson at a Lawrenceville home on Clairidge Lane on June 27. Firefighters responded to a fire alarm and smoke report, discovering an incendiary device behind the home. The fire was out by the time they arrived, and no injuries were reported. Officials are seeking public help to identify the suspect, with a potential reward of up to $10,000 for information leading to an arrest and conviction. Tips can be directed to the Gwinnett Fire Investigations Section or the Georgia Arson Control Hotline. We’ll have closing comments after this Break 4: Ingles Markets 2 Signoff – Thanks again for hanging out with us on today’s Gwinnett Daily Post Podcast. If you enjoy these shows, we encourage you to check out our other offerings, like the Cherokee Tribune Ledger podcast, the Marietta Daily Journal, or the Community Podcast for Rockdale Newton and Morgan Counties. Read more about all our stories and get other great content at www.gwinnettdailypost.com Did you know over 50% of Americans listen to podcasts weekly? Giving you important news about our community and telling great stories are what we do. Make sure you join us for our next episode and be sure to share this podcast on social media with your friends and family. Add us to your Alexa Flash Briefing or your Google Home Briefing and be sure to like, follow, and subscribe wherever you get your podcasts. Produced by the BG Podcast Network Show Sponsors: ingles-markets.com kiamallofga.com See omnystudio.com/listener for privacy information.

In this eye-opening episode of The Brian Nichols Show, we rip the mask off the growing crusade against pharmacy benefit managers (PBMs). Critics claim PBMs are behind rising drug costs, but is that the full story - or just the version Big Pharma wants you to believe? If you've ever looked at your pharmacy receipt and wondered why your medication costs more than your electric bill, you won't want to miss this deep dive. Studio Sponsor: Cardio Miracle - "Unlock the secret to a healthier heart, increased energy levels, and transform your cardiovascular fitness like never before.": CardioMiracle.com/TBNS Brian welcomes economist and researcher Satya Marar from the Mercatus Center to break down how PBMs actually work, why they're being blamed for high drug prices, and what the real drivers of healthcare inflation are. Together, they dismantle the most common talking points against PBMs, including rebate manipulation, lack of transparency, spread pricing, and claims of collusion with insurers. It's a masterclass in separating economic fact from political fiction. We also unpack the emotional tug-of-war between small-town pharmacies and corporate chains. What happens when “Fred's Pharmacy” can't compete with CVS and Walgreens? Is it worth paying more for drugs to keep the local guy afloat - or are there smarter ways to balance access, cost, and community values without wrecking the system? But here's the kicker: what if the real culprit isn't the PBMs at all, but a broken government pricing system and global freeloading by other countries? Yeah, we go there. From Medicare's price models to how the U.S. subsidizes R&D for the world, we expose what's actually driving your pill prices through the roof. If you're sick of the soundbites and want real answers about the mess that is American drug pricing - this episode delivers. Tune in, take notes, and walk away with a smarter, sharper view of healthcare economics than most politicians will ever have. ❤️ Order Cardio Miracle (CardioMiracle.com/TBNS) for 15% off and take a step towards better heart health and overall well-being!

Is the war on PBMs really about helping patients - or just another power grab dressed up as reform? In this eye-opening episode of The Brian Nichols Show, we rip the mask off the growing crusade against pharmacy benefit managers (PBMs). Critics claim PBMs are behind rising drug costs, but is that the full story - or just the version Big Pharma wants you to believe? If you've ever looked at your pharmacy receipt and wondered why your medication costs more than your electric bill, you won't want to miss this deep dive. We have a new show on Lions of Liberty! The Politicks Podcast! Be sure to subscribe to the standalone Politicks Podcast feed. This is the absolute best way to support the show! Listen and subscribe on Apple Podcasts and Spotify. And remember, they're all Blood Suckers! Studio Sponsor: ⁠Cardio Miracle⁠ - "Unlock the secret to a healthier heart, increased energy levels, and transform your cardiovascular fitness like never before.": ⁠CardioMiracle.com/TBNS⁠ Brian welcomes economist and researcher Satya Marar from the Mercatus Center to break down how PBMs actually work, why they're being blamed for high drug prices, and what the real drivers of healthcare inflation are. Together, they dismantle the most common talking points against PBMs, including rebate manipulation, lack of transparency, spread pricing, and claims of collusion with insurers. It's a masterclass in separating economic fact from political fiction. We also unpack the emotional tug-of-war between small-town pharmacies and corporate chains. What happens when “Fred's Pharmacy” can't compete with CVS and Walgreens? Is it worth paying more for drugs to keep the local guy afloat - or are there smarter ways to balance access, cost, and community values without wrecking the system? But here's the kicker: what if the real culprit isn't the PBMs at all, but a broken government pricing system and global freeloading by other countries? Yeah, we go there. From Medicare's price models to how the U.S. subsidizes R&D for the world, we expose what's actually driving your pill prices through the roof. If you're sick of the soundbites and want real answers about the mess that is American drug pricing - this episode delivers. Tune in, take notes, and walk away with a smarter, sharper view of healthcare economics than most politicians will ever have. Order ⁠Cardio Miracle⁠ (⁠CardioMiracle.com/TBNS⁠) for 15% off and take a step towards better heart health and overall well-being!Submit Listener Questions to ⁠brian@briannicholsshow.com⁠ to hear your questions and perspectives answered and shared each and every week! WATCH The Brian Nichols Show, available on ⁠YouTube⁠ & ⁠Rumble⁠. With over 990 episodes featuring local candidates, elected officials, economists, CEOs, and more, each show educates, enlightens, and informs. Follow Brian on social media: X.com/Twitter ⁠(https://www.briannicholsshow.com/twitter⁠) & Facebook (⁠https://www.briannicholsshow.com/facebook⁠) Don't forget to like, share, and subscribe to ⁠The Brian Nichols Show ⁠for more captivating interviews and insights into common sense solutions for local problems! Learn more about your ad choices. Visit megaphone.fm/adchoices

Is the war on PBMs really about helping patients - or just another power grab dressed up as reform? In this eye-opening episode of The Brian Nichols Show, we rip the mask off the growing crusade against pharmacy benefit managers (PBMs). Critics claim PBMs are behind rising drug costs, but is that the full story - or just the version Big Pharma wants you to believe? If you've ever looked at your pharmacy receipt and wondered why your medication costs more than your electric bill, you won't want to miss this deep dive. We have a new show on Lions of Liberty! The Politicks Podcast! Be sure to subscribe to the standalone Politicks Podcast feed. This is the absolute best way to support the show! Listen and subscribe on Apple Podcasts and Spotify. And remember, they're all Blood Suckers! Studio Sponsor: ⁠Cardio Miracle⁠ - "Unlock the secret to a healthier heart, increased energy levels, and transform your cardiovascular fitness like never before.": ⁠CardioMiracle.com/TBNS⁠ Brian welcomes economist and researcher Satya Marar from the Mercatus Center to break down how PBMs actually work, why they're being blamed for high drug prices, and what the real drivers of healthcare inflation are. Together, they dismantle the most common talking points against PBMs, including rebate manipulation, lack of transparency, spread pricing, and claims of collusion with insurers. It's a masterclass in separating economic fact from political fiction. We also unpack the emotional tug-of-war between small-town pharmacies and corporate chains. What happens when “Fred's Pharmacy” can't compete with CVS and Walgreens? Is it worth paying more for drugs to keep the local guy afloat - or are there smarter ways to balance access, cost, and community values without wrecking the system? But here's the kicker: what if the real culprit isn't the PBMs at all, but a broken government pricing system and global freeloading by other countries? Yeah, we go there. From Medicare's price models to how the U.S. subsidizes R&D for the world, we expose what's actually driving your pill prices through the roof. If you're sick of the soundbites and want real answers about the mess that is American drug pricing - this episode delivers. Tune in, take notes, and walk away with a smarter, sharper view of healthcare economics than most politicians will ever have. Order ⁠Cardio Miracle⁠ (⁠CardioMiracle.com/TBNS⁠) for 15% off and take a step towards better heart health and overall well-being!Submit Listener Questions to ⁠brian@briannicholsshow.com⁠ to hear your questions and perspectives answered and shared each and every week! WATCH The Brian Nichols Show, available on ⁠YouTube⁠ & ⁠Rumble⁠. With over 990 episodes featuring local candidates, elected officials, economists, CEOs, and more, each show educates, enlightens, and informs. Follow Brian on social media: X.com/Twitter ⁠(https://www.briannicholsshow.com/twitter⁠) & Facebook (⁠https://www.briannicholsshow.com/facebook⁠) Don't forget to like, share, and subscribe to ⁠The Brian Nichols Show ⁠for more captivating interviews and insights into common sense solutions for local problems! Learn more about your ad choices. Visit megaphone.fm/adchoices

This Week in Pharmacy – June 27, 2025 Episode Title: “Going on the Offensive to Protect Public Health”

* Is there a conflict of interest with the GATOR scholarship program? * How pharmacy benefit managers work...and what it means for patients * Churchill Downs tried to bluff lawmakers with the Fair Grounds future * City Park has a plan for the future. Here are the details * Buy Now, Pay Later plans will soon affect your credit score * Breaking down the Pelicans picks and moves in the first round * What we know about Alzheimer's and what to watch for

What does one do after selling their company to Amazon for $1 billion? Start a new one, of course.In this episode, Halle sits down with TJ Parker, pharmacist, entrepreneur, and advocate for consumer-centric digital health. After co-founding PillPack and selling it to Amazon, TJ stayed on for four years helping build Amazon Pharmacy. Now, he's back at it with General Medicine, a new company focused on making care as seamless as any other online transaction.We cover:

In this relaunch of the PBM Reform Podcast, Greg Reybold returns with a powerful and timely conversation exploring how concentrated economic power—particularly in the form of Pharmacy Benefit Managers (PBMs)—is undermining fair access to prescription medications, driving up drug costs, and crushing independent pharmacies. Greg is joined by Emma Freer, Senior Policy Analyst with the American Economic Liberties Project, a national non-profit and non-partisan organization dedicated to dismantling monopolistic control across critical sectors—including healthcare. Together, they dig deep into how PBMs serve as gatekeepers in the drug supply chain, extracting value at the expense of patients and providers, and how policy reform is urgently needed. Emma outlines how Economic Liberties is driving a new wave of anti-monopoly policy momentum in healthcare by advocating for stronger antitrust enforcement, corporate accountability, and legislative transparency. She highlights how concentrated PBM power not only threatens economic fairness but undermines public health outcomes.

Heather and Matthew welcome Chuck Melendi, a seasoned healthcare consultant and former executive with decades of experience in pharmaceuticals, biotech, and medical devices. Chuck joins us to examine the complexities of the federal 340B pricing program, which provides discounted outpatient drugs to eligible health care providers. From ongoing litigation and proposed legislative reform to the role of PBMs, Chuck shares insights into why a seemingly good faith regulation is one of the most debated topics in health care policy. Tune in for a thoughtful discussion on how healthcare leaders and government can preserve the mission of 340B while addressing its challenges.

We pick our conversation about pharmacy benefit managers back up and talk with Al Spitale, a pharmacist at Majoria Drugs

* How will the Tigers respond when the game resumes? * A local pharmacist explains how PBMs work and the effect they're having * What was up with that weird Soil and Water Conservation District election? * How is the Israel/Iran conflict likely to affect oil and gas prices? * LSU really needs to beat UCLA to avoid a brutal schedule * This state senator helped make grooming a crime

In this episode, Chad Robichaux is joined by healthcare reformer & founder of Ways2Well, Brigham Buhler.Brigham uncovers the truth about the pharmaceutical industry, insurance company kickbacks, & why effective treatments like Ibogaine, stem cells, and peptides are being suppressed. He shares his personal journey from launching Cialis as a young pharma rep to walking away from the industry after seeing how off-label promotion, lobbying, and corporate greed were harming patients, especially veterans.He also breaks down the FDA's role in blocking alternative therapies, the corrupt relationship between PBMs and Big Pharma, and how he's fighting back through legislation and his own medical companies. If you've ever felt like the system is stacked against your health, this conversation will open your eyes.Brigham Buhler is the founder and CEO of Ways2Well and Revive Pharmacy. A former pharmaceutical rep, he's now a leading voice in the fight for patient-first, preventative care and healthcare transparency. His testimony before the Senate, viral appearance on Joe Rogan, and ongoing collaboration with leaders like RFK Jr. have made him one of the most trusted names in healthcare reform today.Learn more about Brigham & Ways2Well: https://ways2well.comFollow Brigham: https://www.instagram.com/brigham.buhlerRESILIENT:Live Resilient Store: https://theresilientshow.com/live-resilient-storeJoin Our Patreon: https://patreon.com/theresilientshowFollow Us On Instagram: https://www.instagram.com/resilientshowFollow Us On Twitter:⁠ https://twitter.com/resilientshowFollow Us On TikTok: ⁠https://www.tiktok.com/@resilientshowFollow Chad:⁠https://www.instagram.com/chadrobo_official⁠https://www.x.com/chadroboSPONSORS:Smith & Wesson: ⁠https://www.smith-wesson.com/⁠Vortex Optics:https://vortexoptics.comGatorz Eyewear: ⁠https://www.gatorz.com/⁠Allied Wealth:https://alliedwealth.comBioPro+: ⁠https://www.bioproteintech.com/⁠BioXCellerator:https://www.bioxcellerator.comThe Holy Waters:https://theholywaters.comGet The Resilient Show x Uncharted Supply Co Bag: https://liveresilient.com/shopTRS is a proud supporter of military & first responder communities in partnership with Mighty Oaks Foundation.

If there's one name to know in the fight for PBM reform, it's Benjamin Jolley. As Co-Founder of Apex Consulting and Senior Fellow at the American Economic Liberties Project, Ben has spent years exposing what's been broken in the pharmacy system—and what can still be fixed. Most recently, he addressed 20,000 attendees at a rally in Salt Lake City to advocate for Breaking Up Big Medicine (breakupbigmedicine.com). This week, Ben joins us on the Catalyst Pharmacy Podcast to talk about all things advocacy, legislation, and fighting for what's right from the front lines of the pharmacy all the way to Capitol Hill.  2:45 – Opening discussion on PBM reform momentum 8:16 – Legislative wins for pharmacy 11:44 – Banning vertical integration between PBMs and pharmacies 14:03 – “Break Up Big Medicine” campaign details 21:37 – Mandatory NADAC reporting: what's required and what it solves 29:36 – Chain vs. independent pricing: real-world examples of inequality 36:14 – Helping pharmacies with Medicare plan optimization 47:51 – Final thoughts and call to action for community involvement  Benjamin's Substack: https://benjaminjolley.substack.com/ Apex Consulting: https://www.apexpharmacyconsulting.com/  Hosted By: Mark Bivins | Chief Growth Officer, RedSail Technologies Guest: Benjamin Jolley | Pharmacist at Jolley's Compounding Pharmacy  Looking for more information about independent pharmacy? Visit https://www.redsailtechnologies.com 

In this Vital Health Podcast, host Duane Schulthess speaks with Jocelyn Ulrich, Vice President of Policy and Research at PhRMA, to discuss the far-reaching implications of current U.S. drug pricing and reimbursement policies. With a unique journey from opera stages to Senate testimony, Ulrich brings both strategic acumen and firsthand experience in navigating complex policy terrain. The conversation explores PBM consolidation, the fallout from the Inflation Reduction Act, vertical integration in biosimilars, and looming tariff threats - all through the lens of innovation, patient access, and economic resilience. Key Topics PBM Consolidation Concerns: Three PBMs now control 80% of U.S. prescriptions, raising red flags over patient steering, inflated costs, and limited access. IRA's Small-Molecule Penalty: The Inflation Reduction Act's nine-year price-setting for pills versus thirteen for biologics is shrinking investment in elderly-targeted therapies. Vertical Integration in Biosimilars: Insurers and PBMs are now owning biosimilars and pharmacies, limiting patient options and delaying uptake of lower-cost treatments. Tariff Risks and U.S. Manufacturing: Proposed pharmaceutical tariffs could undermine domestic production despite the sector’s significant economic footprint and current exemptions. Rebuilding Innovation Incentives: From the EPIC Act to patient-first rebate reform, industry stakeholders are pushing for legislative fixes that sustain R&D and reduce care disparities. This episode unpacks how policy shifts are reshaping biopharma’s incentive structures, investment flows, and ultimately, patient outcomes. Essential listening for policymakers, investors, and health economists seeking clarity on U.S. pharmaceutical policy and its global ripple effects.See omnystudio.com/listener for privacy information.

The cost of healthcare is a concern nationwide, but Arkansas is trying to lead the way in bringing price relief to patients, particularly when it comes to prescription drugs. Governor Sarah Huckabee Sanders recently signed a new law banning pharmacy benefits managers from owning and operating pharmacies in her state. PBMs are third-party companies that act as intermediaries or middlemen between insurance companies, big pharma, and pharmacies and are supposed to negotiate for lower costs through rebates and discounts. However, President Trump and his administration have recently called them out for helping to drive up the price of drugs in the country. Governor Sarah Huckabee Sanders joins the Rundown to explain her state's efforts to get prices down and how she hopes other states and the federal government will follow Arkansas's lead. While the President's tariff strategy and efforts to reshape what he sees as an unfair trade system have created some uncertainty on both Wall Street and Main Street, the latest jobs data suggest the labor market is holding steady. Many investors took Friday's May jobs report as a sign that a recession isn't imminent. However, the housing market, inflation, interest rates, and other factors are still a concern. FOX Business Network's Gerri Willis joins the Rundown to discuss the state of the economy, including why she believes the housing market is under pressure but remains optimistic about the American consumer. Plus, commentary from RNC Youth Advisory Council Chair, Brilyn Hollyhand. Learn more about your ad choices. Visit podcastchoices.com/adchoices

The cost of healthcare is a concern nationwide, but Arkansas is trying to lead the way in bringing price relief to patients, particularly when it comes to prescription drugs. Governor Sarah Huckabee Sanders recently signed a new law banning pharmacy benefits managers from owning and operating pharmacies in her state. PBMs are third-party companies that act as intermediaries or middlemen between insurance companies, big pharma, and pharmacies and are supposed to negotiate for lower costs through rebates and discounts. However, President Trump and his administration have recently called them out for helping to drive up the price of drugs in the country. Governor Sarah Huckabee Sanders joins the Rundown to explain her state's efforts to get prices down and how she hopes other states and the federal government will follow Arkansas's lead. While the President's tariff strategy and efforts to reshape what he sees as an unfair trade system have created some uncertainty on both Wall Street and Main Street, the latest jobs data suggest the labor market is holding steady. Many investors took Friday's May jobs report as a sign that a recession isn't imminent. However, the housing market, inflation, interest rates, and other factors are still a concern. FOX Business Network's Gerri Willis joins the Rundown to discuss the state of the economy, including why she believes the housing market is under pressure but remains optimistic about the American consumer. Plus, commentary from RNC Youth Advisory Council Chair, Brilyn Hollyhand. Learn more about your ad choices. Visit podcastchoices.com/adchoices

The cost of healthcare is a concern nationwide, but Arkansas is trying to lead the way in bringing price relief to patients, particularly when it comes to prescription drugs. Governor Sarah Huckabee Sanders recently signed a new law banning pharmacy benefits managers from owning and operating pharmacies in her state. PBMs are third-party companies that act as intermediaries or middlemen between insurance companies, big pharma, and pharmacies and are supposed to negotiate for lower costs through rebates and discounts. However, President Trump and his administration have recently called them out for helping to drive up the price of drugs in the country. Governor Sarah Huckabee Sanders joins the Rundown to explain her state's efforts to get prices down and how she hopes other states and the federal government will follow Arkansas's lead. While the President's tariff strategy and efforts to reshape what he sees as an unfair trade system have created some uncertainty on both Wall Street and Main Street, the latest jobs data suggest the labor market is holding steady. Many investors took Friday's May jobs report as a sign that a recession isn't imminent. However, the housing market, inflation, interest rates, and other factors are still a concern. FOX Business Network's Gerri Willis joins the Rundown to discuss the state of the economy, including why she believes the housing market is under pressure but remains optimistic about the American consumer. Plus, commentary from RNC Youth Advisory Council Chair, Brilyn Hollyhand. Learn more about your ad choices. Visit podcastchoices.com/adchoices

EP. 215: I sat down with Brad Hart, owner of Forest Park Pharmacy in Fort Worth, to expose the shocking truth behind pharmacy benefit managers (PBMs) and how they're driving up drug prices. What I learned about vertical integration in the healthcare system, where insurers own the PBMs and the pharmacies, honestly left me furious. Brad breaks it all down, from Medicare waste to the skyrocketing cost of specialty drugs, and we talk about real solutions like compounding pharmacies and direct-to-consumer options. This is a must-listen if you've ever wondered why your medications cost so much—and who's really profiting. Topics Discussed:  What are pharmacy benefit managers (PBMs) and how do they increase drug prices? How are health insurance companies profiting from vertical integration in the pharmacy system? Why are independent and rural pharmacies struggling to stay open? What impact do PBMs have on Medicare spending and prescription drug costs? How can consumers save money on medications without relying on insurance? Sponsored By: Qualia | Go to qualialife.com/DRTYNA for up to 50% off your purchase and use code DRTYNA for an additional 15% Maui Nui Venison | Head to mauinuivenison.com/DRTYNA to secure your access now.  LMNT | Get your free Sample Pack with any LMNT purchase at drinkLMNT.com/drtyna BIOptimizers | Go to bioptimizers.com/tyna and use promo code TYNA10 to order Masszymes now and get 10% off any order Sundays | Get 40% off your first order of Sundays. Go to sundaysfordogs.com/DRTYNA and use code DRTYNA at checkout. Relax Tonic | Go to https://store.drtyna.com/products/relaxtonic and use code and use DRTYNASHOW to save 10% On This Episode We Cover:  00:00:00 - Introduction  00:04:34 - History of PBMs 00:09:02 - Insurance & Pharmacy Ties 00:12:17 - UnitedHealthcare's Role 00:15:59 - Pharmacy Kickbacks 00:18:01 - Emergency Med Access 00:23:11 - Rural Pharmacy Crisis 00:26:20 - How Insurance Works 00:30:05 - Compounding Pharmacies Explained 00:35:19 - How Pharmacies Save Money 00:37:14 - Arkansas PBM Bill 00:39:12 - Trump's Drug Pricing Executive Order 00:42:37 - Direct-to-Consumer Drugs 00:43:40 - Wegovy, Eli Lilly, & Changing Costs 00:46:27 - Medicare Waste 00:48:25 - Medicare Price Negotiation 00:49:58 - Specialty Drug Cost 00:54:18 - Brad's Pharmacy Model Further Listening:  The Fight For Affordable GLP1s & The Truth About Big Pharma | Dave Knapp  Check Out Brad:  https://www.forestparkpharmacy.com/ Instagram TikTok YouTube Disclaimer: Information provided in this podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional, or any information contained on or in any product. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or other supplement, or using any treatment for a health problem. Information provided in this blog/podcast and the use of any products or services related to this podcast by you does not create a doctor-patient relationship between you and Dr. Tyna Moore. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease.

253: In this special episode recorded live from the White House, I sit down with some of the most influential voices shaping the future of health in America to discuss the newly released Make America Healthy Again (MAHA) Report. Guests include Dr. Oz, Kyle Diamantas, Vani Hari, Anthony Geisler, Brigham Buhler, and Max Lugavere. We dive into key topics like food policy, GRAS regulations, Medicaid and SNAP reform, PBMs, Alzheimer's research, and the push for preventative care, movement, and accountability in federal health initiatives. This is a behind-the-scenes look at how the MAHA coalition is working to make real change—and what it means for your health. Topics Discussed:  What is the Make America Healthy Again (MAHA) Report, and how does it aim to transform public health policy? How is the FDA planning to update GRAS regulations and food safety standards under the MAHA initiative? What changes are being proposed for Medicaid, Medicare, and SNAP benefits to support preventative health care? Why are PBMs (pharmacy benefit managers) under scrutiny, and how is the MAHA movement addressing prescription drug pricing? What are the latest findings on Alzheimer's disease research, and how is fraudulent science being addressed in national policy? Sponsored By: Beekeepers Naturals | Go to beekeepersnaturals.com/REALFOODOLOGY or enter code REALFOODOLOGY to get 20% off your order.  MASA | Go to MASAChips.com/Realfoodology and use code Realfoodology for 25% off your first order. Ollie | Head to MyOllie.com/REALFOODOLOGY, tell them all about your dog, and use code REALFOODOLOGY to get 60% off your Welcome Kit when you subscribe today!  Timestamps:   00:00:00 - Introduction  00:04:01 - Dr. Oz on CMS & Health Policy 00:06:09 - What MAHA Means for Real Food 00:07:28 - SNAP, Medicaid & Prevention 00:09:33 - Food Access & Health Equity 00:12:21 - Medicaid Waste & ACA Reform 00:15:16 - Movement, Sleep & Food w/ Anthony Geisler 00:17:14 - MAHA's Core 4 Explained 00:18:58 - Building Daily Healthy Habits 00:23:31 - Fitness Access in Schools & Communities 00:26:35 - Avoiding Burnout & Staying Consistent 00:29:33 - Kyle Diamantas on the MAHA Report 00:32:42 - GRAS Status & FDA Priorities 00:36:15 - FDA Reform & Food Regulation 00:39:26 - Red Dye, Food Bans & Ingredient Risks 00:42:14 - Vani Hari on MAHA & Food Advocacy 00:47:54 - Government Response to Health Demands 00:50:52 - MAHA Criticism & What's Ahead 00:56:06 - Fixing How We Grow & Source Food 00:59:59 - Whole Foods, Prevention & EO Impact 01:01:22 - Alzheimer's Fraud & Science Gaps 01:05:29 - New Alzheimer's Therapies & Creatine 01:10:38 - Brigham Buhler on FDA & Reform Efforts 01:12:05 - FDA Accountability & Future Goals 01:14:13 - GRAS Loopholes & Public Safety 01:15:55 - Strengthening Health Safety Nets 01:18:43 - Medical Overuse & Systemic Issues 01:20:30 - What Are PBMs & Why They Matter 01:23:10 - U.S. vs. Global Drug Pricing 01:24:18 - Trump's EO & Cutting Out PBMs 01:26:33 - Insurance Denials & Patient Delays 01:29:10 - Insurance Fixes from the Ground Up 01:32:21 - Progress in Reforming Health Insurance Show Links: Former Pharma Rep Breaks Down How Your Insurance Is Overcharging You + Keeping You Sick | Brigham Buhler Check Out:  Dr. Oz Anthony Geisler, CEO of Sequel Brands Kyle Diamantas Vani Hari Max Lugavere Brigham Buhler Check Out Courtney:  LEAVE US A VOICE MESSAGE Check Out My new FREE Grocery Guide! @realfoodology www.realfoodology.com My Immune Supplement by 2x4 Air Dr Air Purifier AquaTru Water Filter EWG Tap Water Database Produced By: Drake Peterson

Life Sciences Partner Stephanie Trunk and Life Sciences Regulatory and Compliance Attorney Darshan Kulkarni delve into the nuances of direct-to-patient (DTP) and direct-to-consumer (DTC) models in the pharmaceutical industry. This encompasses advertising on drug prices, the intricacies of cash pay programs, and the evolving role of pharmacy benefit managers (PBMs). They also discuss the Trump Administration's most favored nation status, as well as regulatory challenges and the need for a unified strategy to tackle rising health care costs. Highlights of the conversation include: - The prevalence of DTC advertising in the United States and its impact on drug sales. - How the Trump Administration's stance on DTC advertising raises First Amendment concerns. - How the most favored nation status could reshape drug pricing strategies. - PBMs playing a critical role in managing drug costs but face scrutiny for their practices. - Why regulatory compliance is essential for companies engaging in DTP sales.

We in the U.S. pay the highest prescription drug prices in the world, and a recent executive order takes aim at that inequity, the result of which remains to be seen. Clark explains why employee health plan drug prices through PBMs remain so high, and what you can do about it.  Speaking of prices, what's behind the sticker shock from the price of beef these days? Clark explains. PBMs & Rx Pricing: Segment 1 Ask Clark: Segment 2 Beef Prices: Segment 3 Ask Clark: Segment 4 Mentioned on the show: Trump to sign executive order to cut prices of medicine to match other countries Warning: One Way You Should Almost Never Fill Prescriptions 10 Ways To Save on Prescription Drugs 7 Things To Know About Costco Pharmacy Should You Buy an Extended Warranty on Your Car? What Is a Fiduciary Financial Advisor and Do I Need One? How To Find and Choose a Financial Advisor What Is Umbrella Insurance and Do You Need It? US beef prices extend surge as ranchers face thinnest herds in 70 years Robinhood Review: Pros, Cons & Who Should Use It The WSJ's Jonathan Clements Wants to Leave a Living Legacy Clark.com resources: Episode transcripts Community.Clark.com  /  Ask Clark Clark.com daily money newsletter Consumer Action Center Free Helpline: 636-492-5275 Learn more about your ad choices: megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, we deliver a critical update on the rapidly evolving legislative landscape impacting rheumatology. We explore the intense policy battles shaping the future of the field, including steep Medicare reimbursement cuts threatening the survival of many practices. We also examine the ongoing challenges posed by pharmacy benefit managers (PBMs) and the growing uncertainty around research funding. Joining us is a special guest, Lennie Shewmaker McDaniel, JD, who brings a firsthand perspective from Capitol Hill, shedding light on what it truly takes to advocate for our patients and the profession in today's complex policy environment. 

Tune in as Glenn Hunzinger, PwC's Health Industries Leader, and Phil Scalfani, PwC's Pharmaceutical and Life Sciences Consulting Leader, discuss the Trump administration's executive order on Most Favored Nation (MFN) drug pricing and its far-reaching implications across the healthcare ecosystem. They break down what MFN pricing could mean for pharmaceutical companies, payers, PBMs, and the broader drug supply chain, and share perspectives on how organizations can navigate the uncertainty ahead.  Discussion Highlights: The MFN executive order is a bold attempt to lower U.S. drug prices by benchmarking them against the lowest prices paid in other high-income countriesPharma companies may be forced to rethink global pricing strategies, balancing U.S. price cuts with potential increases or market exits abroadA proposed shift to direct-to-consumer drug access could disrupt traditional roles for pharmacies, distributors, and pharmacy benefit managers (PBMs)Companies are preparing for significant uncertainty by reassessing deals, modeling financial impacts, and closely monitoring upcoming rulemaking and potential legal developmentsSpeakers:Glenn Hunzinger, Health Industries Leader, PwCPhilip Sclafani, Partner, Pharma & Life Sciences, PwCLinked materials:Most Favored Nation prescription drug pricing Executive OrderFor more information, please visit us at: https://www.pwc.com/us/en/industries/health-industries/health-research-institute/next-in-health-podcast.html.

I sat down with Benjamin Jolley, a third-generation pharmacist who recently addressed a crowd of 20,000 about the broken world of PBMs. We dug into the power of that moment, the hidden mechanics of pharmacy monopolies, and what real reform could look like. This one hits where policy meets reality.

We were honored to deliver the closing keynote at #CAHR25, and we've been bringing it to you in a powerful 3-part series.In this final installment, we dive deep into the world of Pharmacy spend—covering everything from rebates and PBMs to real, actionable strategies for cost containment.Then we shift gears to explore the often-overlooked but essential ancillary benefits:✔️ Dental✔️ Vision✔️ Disability✔️ Life and moreIf you missed Parts 1 or 2, go back and catch up! This finale ties it all together with high-impact insights every employer should hear.About the Show:The H.I.T. Podcast (Powered by Montage Insurance Solutions): A thought leader in the space, curating the top news and information to deliver a brief, high impact overview designed specifically for the Human Resources professional, business person, and company executive.Find out more here: www.hitpodcast.com

In this episode of the Astonishing Healthcare podcast, Justin Venneri speaks with Kristin Begley, PharmD, Chief Commercial Officer at Capital Rx, about the evolving role of Pharmacy Benefit Managers (PBMs) and the rapidly accelerating shift in demand for an "unbundled," agnostic model. But what does unbundling mean? How does this approach help to avoid conflicts of interest? What parts of a pharmacy program can be carved out or unbundled to allow plan sponsors the freedom to design a plan that meets their unique populations' needs? Kristin answers these questions and more during the conversation, and she also explains what's so astonishing about the Trump administration's executive order aimed at addressing global drug price disparities!Related ContentReplay - Build a Lasting Pharmacy Benefit Strategy with Never Move Again™Pharmacy Benefits 101: The Importance of the NetworkReplay - Strategic Well-Being: Rethinking Health Benefits to Empower Employees and Drive ImpactSigns it is time to change your PBM vendor, and how to overcome common hesitationsAH041 - ERISA Litigation Outlook and Meeting CAA Requirements: What Can Plan Fiduciaries Do?For more information about Capital Rx and this episode, please visit Capital Rx Insights.

Understanding Trump's Executive Order on Drug Pricing | ShiftShapersIn this episode of ShiftShapers, host David A. Saltzman welcomes Tiffany Ryder, emergency medicine PA, host of Healthcare Liberty Lab, and writer at Red Flag Hero on Substack. Tiffany breaks down President Trump's executive order on drug pricing and what it could mean for patients, providers, and pharmaceutical companies.She explores key issues like most favored nation pricing, transparency in drug costs, and the role of PBMs and middlemen. Drawing from her frontline experience and policy knowledge, Tiffany explains how these changes may impact everything from consumer behavior to research and development in the pharmaceutical world.

Analyzing Trump's plan to roll back soaring drug prices for Americans; Sports bras eliminate bounce but may take a toll on women's backs; RFK Jr. targets the chemicals in our food; Do Americans really eat more animal protein than any other of the world's nations? Causes and treatments for pulmonary hypertension.

(0:00) The Besties welcome Ben Shapiro! (1:53) A Bestie apology to Phil Hellmuth, All-In Poker Tournament (7:58) Trump's majorly consequential Middle East trip: Saudi, Qatar, Iran, and his vision for a "New Middle East" (35:18) US-China deal: is the tide turning on tariffs? (46:33) GOP divided over "Big, Beautiful Bill" due to its impact on our debt spiral (1:18:48) Science Corner: Montana bans cell-based meat, joining Florida and others (1:24:31) Trump's EO on pharma prices: role of PBMs, is this too much government intervention? Follow Ben Shapiro: https://x.com/benshapiro Follow the besties: https://x.com/chamath https://x.com/Jason https://x.com/DavidSacks https://x.com/friedberg Follow on X: https://x.com/theallinpod Follow on Instagram: https://www.instagram.com/theallinpod Follow on TikTok: https://www.tiktok.com/@theallinpod Follow on LinkedIn: https://www.linkedin.com/company/allinpod Intro Music Credit: https://rb.gy/tppkzl https://x.com/yung_spielburg Intro Video Credit: https://x.com/TheZachEffect Referenced in the show: https://www.whitehouse.gov/fact-sheets/2025/05/fact-sheet-president-donald-j-trump-secures-historic-1-2-trillion-economic-commitment-in-qatar https://www.whitehouse.gov/fact-sheets/2025/05/fact-sheet-president-donald-j-trump-secures-historic-600-billion-investment-commitment-in-saudi-arabia https://www.whitehouse.gov/articles/2025/05/in-riyadh-president-trump-charts-the-course-for-a-prosperous-future-in-the-middle-east https://www.semafor.com/article/05/16/2025/qatar-commits-more-than-200-billion-in-us-investment https://www.cnbc.com/2025/05/13/trump-saudi-investment-speech.html https://www.cnbc.com/2025/05/13/trump-says-us-will-remove-all-sanctions-on-syria.html https://www.reuters.com/world/what-have-china-united-states-agreed-geneva-2025-05-12 https://www.cnn.com/2019/07/02/politics/donald-trump-dictators-kim-jong-un-vladimir-putin https://newrepublic.com/post/185836/trump-brags-dictators-orban-debate-harris https://www.cnbc.com/quotes/US30Y https://www.politico.com/live-updates/2025/05/14/congress/the-titanic-johnson-predicts-houses-big-beautiful-reconciliation-bill-will-sink-in-the-senate-00348310 https://fred.stlouisfed.org/series/GFDEBTN https://fred.stlouisfed.org/series/GFDEGDQ188S https://www.nytimes.com/2025/05/12/opinion/josh-hawley-dont-cut-medicaid.html https://www.whitehouse.gov/fact-sheets/2025/05/fact-sheet-president-donald-j-trump-announces-actions-to-put-american-patients-first-by-lowering-drug-prices-and-stopping-foreign-free-riding-on-american-pharmaceutical-innovation/

EP. 212: Today I'm joined by Dr. Spencer Nadolsky, obesity specialist, Lipidologist, and founder of Vineyard, a cutting-edge direct care platform. We're diving deep into the conversation you've been asking for: the real story behind GLP-1s, obesity as a chronic disease, and why treating it goes far beyond weight loss. We break down everything from proper dosing, common side effects, and the dangers of vanity prescribing to the systemic issues with telemedicine and PBMs. Dr. Nadolsky and I also discuss strength training, preserving muscle mass, and how GLP-1s may support metabolic and cardiovascular health beyond their FDA indications. This episode cuts through the noise and misinformation. If you care about metabolic health, this one's essential. Topics Discussed:  What are the real benefits of GLP-1 medications beyond weight loss? Is obesity truly a chronic disease, and how should it be treated? What are the risks of GLP-1 vanity dosing and fast titration? How do GLP-1s impact muscle mass and metabolic health? Why are telemedicine and PBMs problematic for obesity treatment? Sponsored By: Maui Nui Venison | Head to mauinuivenison.com/DRTYNA to secure your access now.  LMNT | Get your free Sample Pack with any LMNT purchase at drinkLMNT.com/drtyna Qualia | Go to qualialife.com/DRTYNA for up to 50% off your purchase and use code DRTYNA for an additional 15% Liver Love | Go to https://store.drtyna.com/products/liverlove Use code LIVER20 for 20% off On This Episode We Cover:  00:00:00 – Introduction  00:02:48 – GLP-1 Dosing  00:06:35 – Side Effects of Vanity Dosing 00:08:51 – Reducing GLP-1 Dosing 00:12:27 – Med Spas & Telemedicine Risks 00:14:20 – Slow Titration for Better Tolerance 00:18:44 – Pharma Profits & Overdosing 00:20:49 – Obesity Treatment Pre & Post GLP-1s 00:27:58 – Obesity Is a Chronic Disease 00:32:45 – Defining obesity  00:36:16 – The Role of Genetics in Obesity 00:38:59 – Lifestyle Factors Beyond Genetics 00:40:46 – Insurance Barriers & PBM Costs 00:44:37 – Anti-GLP-1 Bias in Healthcare 00:46:22 – Why Strength Training Matters 00:51:39 – New Doctors & Role of AI 00:53:38 – Protecting Muscle on GLP-1s 00:58:55 – No Shortcuts to Health 01:02:01 – The Vineyard Show Links: Glp-1s Can Help Employers Lower Medical Costs In 2 Years, New Study Finds Further Listening GLP1 Uncovered FREE 4 Part Video Series  Ozempic Done Right Playlist EP. 202 | The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knap Check Out Dr. Spencer Vineyard Instagram Website Podcast Disclaimer: Information provided in this podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional, or any information contained on or in any product. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or other supplement, or using any treatment for a health problem. Information provided in this blog/podcast and the use of any products or services related to this podcast by you does not create a doctor-patient relationship between you and Dr. Tyna Moore. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease.

In this episode, host Stacey Richter speaks with Ann Lewandowski about whistleblowing in the healthcare industry, focusing on a significant case involving a whistleblower at an employee benefit consultant (EBC) firm. This EBC allegedly pocketed their clients' pharma rebates, violating the Consolidated Appropriations Act of 2021.  The discussion highlights the nuances of being a whistleblower, the ethical dilemmas faced, compliance challenges, and the significant financial implications for companies and individuals involved in illegal activities.  Ann Lewandowski provides insights into documenting and protecting oneself legally and discusses the broader context of trust and transparency in the healthcare sector. Click through to the show notes below to access all of the mentioned links and prior episodes mentioned. === LINKS ===

Are billion-dollar secrets hiding in plain sight every time you pick up a prescription? While most of us trust the price tags and availability of life-saving medications, who's really pulling the strings—and why aren't these stories front-page news? In an era when legal battles against corporate giants can change lives and headlines, we need transparency and we need it now. This week on Cut to the Chase: Podcast, we're diving deep into the explosive world of pharmaceutical litigation with Mike Papantonio, legendary trial attorney, legal commentator, and acclaimed author. Mike's latest novel “The Middleman” pulls back the curtain on the mysterious—and disturbingly powerful—pharmacy benefit managers (PBMs) who are quietly shaping the cost and availability of vital medicines. The PBM industry is a $300 billion behemoth—raising medication costs across the board by up to 50%. Most Americans, including seasoned professionals, have no idea these gatekeepers exist. Tune in to hear how real courtroom drama translates into gripping fiction, what's really driving up drug prices, and what lawyers must know to make a transformative impact—financially and socially—through mass tort litigation. What you'll learn in this episode: The shocking influence and unchecked power of pharmacy benefit managers (PBMs)—and how they're raising drug prices, taking kickbacks, and operating as a modern-day mob Insider details from landmark cases (tobacco, opioids, human trafficking, Wall Street scams) and how those stories shape Mike's writing The criminal-like conduct behind life-saving drug pricing, vertical integration, and extortion in the pharma industry How whistleblowers drive 40% of mass tort cases—why they matter and how law firms can support them Tips for trial lawyers and young attorneys on building a meaningful, profitable practice—the legacy case approach A sneak peek at Mike's upcoming book, “Death in Arcadia,” exposing corruption and abuse in America's reform schools Key Takeaways: Look Beyond the Headlines: Mainstream media often misses (or avoids) big stories; legal professionals must dig deeper and use insider knowledge to expose injustice. Leverage Whistleblower Potential: Proactively support and educate potential whistleblowers—40% of mass torts begin with insider revelations. Consider Legacy Cases: Don't just chase profits—choose cases that have lasting impact and can become the cornerstone of your reputation. Educate Through Storytelling: Use creative outlets—novels, blogs, podcasts—to inform and inspire both the public and fellow attorneys. Adapt to Changing Legal Landscapes: Stay alert to new threats—PBMs, antitrust schemes, white-collar criminality—that need legal champions willing to take action.   Stay tuned for more updates, and don't miss our next deep dive on Cut to The Chase: Podcast with Gregg Goldfarb!   Subscribe, rate, review, and share this episode of the Cut to the Chase: Podcast!   Resources: Buy “The Middleman: A Legal Thriller” by Mike Papantonio: https://www.amazon.com/dp/1648211054 Connect with Mike Papantonio on LinkedIn: https://www.linkedin.com/in/mikepapantonio  Visit his website - Ring of Fire: https://trofire.com Subscribe to his YouTube channel - America's Lawyer: https://www.youtube.com/@TheRingofFire  Follow Mike on Instagram: https://www.instagram.com/rofpap Learn more about Mike's legal career: https://levinlaw.com/our_team/mike-papantonio    This episode was produced and brought to you by Reignite Media.

We take a deep dive into the lesser-known industry of “pharmacy benefits managers” (PBMs) which are parasitical companies that sit in the middle of the incredibly consolidated and vertically integrated market of pharmaceuticals hospitals insurers pharmacy benefits managers pharmacies. Through the simple administrative business of making lists of drugs and networks of pharmacies, PBMs have managed to carve out a multi-billion dollar rent-seeking industry premised on controlling (and jacking up) how much drugs cost and where you can get them—and extracting as much money as possible from people who need those drugs. ••• Timeline of FTC lawsuit against PBMs and relevant documents: https://www.ftc.gov/legal-library/browse/cases-proceedings/221-0114-caremark-rx-zinc-health-services-et-al-matter-insulin ••• Concurring Statement of Commissioner Andrew N. Ferguson https://www.ftc.gov/system/files/ftc_gov/pdf/Ferguson-Statement-Pharmacy-Benefit-Managers-Report.pdf ••• Market Power and Inequality: The Antitrust Counterrevolution and Its Discontents | Lina Khan and Sandeep Vaheesan https://scholarship.law.columbia.edu/faculty_scholarship/2790/ ••• Inside the Mafia of Pharma Pricing | Matt Stoller https://www.thebignewsletter.com/p/inside-the-mafia-of-pharma-pricing ••• A brief look at current debates about pharmacy benefit managers https://www.brookings.edu/articles/a-brief-look-at-current-debates-about-pharmacy-benefit-managers/ Standing Plugs: ••• Order Jathan's new book: https://www.ucpress.edu/book/9780520398078/the-mechanic-and-the-luddite ••• Subscribe to Ed's substack: https://substack.com/@thetechbubble ••• Subscribe to TMK on patreon for premium episodes: https://www.patreon.com/thismachinekills Hosted by Jathan Sadowski (bsky.app/profile/jathansadowski.com) and Edward Ongweso Jr. (www.x.com/bigblackjacobin). Production / Music by Jereme Brown (bsky.app/profile/jebr.bsky.social)

In this month's Digital Health Download, Steve and Halle unpack the headlines shaping healthcare, policy, and technology—with an eye toward where things may be heading next. From shifting political support for Medicaid and the ACA to state-level action on PBMs, they explore the unexpected ways the system is evolving.We cover:

Ever had to wait 45 minutes in the lobby just to wait another 30 in the exam room while imagining your doctor is in the back watching YouTube? In this episode, I break down what's really going on behind the scenes of a chaotic clinic day—and no, it's not lunch. Plus, a very satisfying rant about healthcare corporatization, a strangely relaxing moment involving blood in the eye (someone else's, not mine), and an update on Arkansas doing something good (I know, I'm surprised too). I also ask an important question: is it fair to say sneezing too hard might ruin your vision? Yes. Yes, it is. Takeaways: If I Could Wire My Brain to Every Patient's Brain, I Would. But since that tech doesn't exist, here's a 45-minute explainer on why your wait time is not me scrolling TikTok in a break room. Private Equity, Insurance Companies, and the Slow Death of My Schedule. Who's really making your doctor run behind? Spoiler: it's not your doctor. Arkansas Just Did Something Cool? I'm Shook. Finally, some legislation that takes aim at PBMs. Can we get 49 more of these, please? Sneezing Shouldn't Break Your Eye… But It Might. A 24-year-old. A sudden cloud in his vision. And the diagnosis I didn't expect to make until he mentioned allergy season. Yes, There Was Blood. But Only a Thimbleful. Ophthalmology is rarely a bloody field. But when it is, it gets… weirdly poetic. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠ http://www.patreon.com/glaucomflecken⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠http://www.EyelidCheck.com⁠ for more information.  Today's episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. To learn more about how DAX Copilot can help improve healthcare experiences for both you and your patients visit ⁠aka.ms/knockknockhi⁠. To learn more about Pearson Ravitz go to http://www.pearsonravitz.com/knockknock. Produced by⁠ Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of the NASP Podcast, Sheila Arquette, President & CEO of NASP, speaks with Jeffrey S. Baird, Esq., Chairman of the Health Care Group at Brown & Fortunato, P.C. and Bradley W. Howard, shareholder and director at Brown & Fortunato, P.C. In today's environment, it is challenging enough to profitably run a specialty pharmacy. The pharmacy needs to avoid the additional challenge of inquiries, audits and investigations by governmental agencies and PBMs. This podcast will discuss the proactive steps the specialty pharmacy can take to lower the risk of inquiries, audits and investigations. This podcast will also set out steps the pharmacy can take to resolve inquiries, audits and investigations before they spin out of control. The podcast will focus on the following: • Corporate Compliance Program – The specialty pharmacy needs to implement a robust compliance program that is specific to the pharmacy's business model. Such a program will head off many problems before they arise…and a compliance program will resolve problems, once arisen, before they spin out of control. • PBMs – A PBM is in a stronger negotiating position than that of the specialty pharmacy. At the end of the day, the PBM “possesses the pharmacy's money.” This podcast will discuss the steps the pharmacy should take to establish a “win-win” relationship with a PBM. Doing so will eliminate uncertainty and prevent many problems from arising. However, if the PBM ends up bringing an inquiry, audit or investigation against the pharmacy, the podcast will set out the steps the pharmacy should take to resolve the inquiry, audit or investigation without it devolving into an adversarial action. • Governmental Agencies – There are a number of federal and state governmental agencies that a specialty pharmacy may have to deal with. These include (i) the Department of Justice, (ii) the Office of Inspector General, (iii) the DEA, (iv) the FDA, (v) state Attorneys General, and (vi) State Boards of Pharmacy. This podcast will discuss the steps the pharmacy should take when it is investigated by a governmental agency. As with working with PBMs, the pharmacy should strive to resolve a government investigation before it spins out of control. 

How One Leader Came Out of Retirement to Transform Home Healthcare Jasper Freeman, Director of National Accounts at SC Pharmaceuticals, didn't just return to medical sales—he came back with a mission to change it. In this episode, Jasper shares how he helped launch Ferosix, a revolutionary heart failure treatment designed to keep patients out of the hospital and improve care at home. But that's just the beginning. We dive into: The untold story of Pharmacy Benefit Managers (PBMs) and their massive influence over drug pricing and access Why the insurance-sales-patient triangle is the key battleground in healthcare innovation What the U.S. can learn from other countries about lowering costs and improving care Bold reform ideas—from slashing med school tuition to rethinking drug distribution This is a rare, behind-the-scenes look at the business of healthcare, guided by someone who's lived it at the highest levels. If you're in medical sales—or trying to break in—this episode is a masterclass on what's next and how to lead the change. Connect with Jasper: LinkedIn Connect with Me: LinkedIn Love the show? Subscribe, rate, review, and share! Here's How » Want to connect with past guests and access exclusive Q&As? Join our EYS Skool Community today!

Ralph speaks to Washington Post columnist Dana Milbank about the Trump Administration's path of destruction in our federal government. Then, Ralph welcomes legendary public interest lawyer Alan Morrison to discuss the President's authority to impose tariffs and other constitutional questions.Dana Milbank is a nationally syndicated op-ed columnist for the Washington Post. He also provides political commentary for various TV outlets, and he is the author of five books on politics, including the New York Times bestseller The Destructionists and the national bestseller Homo Politicus. His latest book is Fools on the Hill: The Hooligans, Saboteurs, Conspiracy Theories and Dunces who Burned Down the House.I shouldn't be amazed, but Mike Johnson never ceases to amaze me with the rapidity with which he'll just drop to his knees whenever Trump says something.Dana MilbankWe're going to know this shortly, but it does appear that Trump's honeymoon may be over in the House as the conservatives finally seem to be finding their backbones. But I've thought that might happen before and then only to find out that they, in fact, they could not locate their backbones. So I don't want to be premature.Dana MilbankTrump seems to be gambling (and the administration seems to be gambling) that ultimately the Supreme Court is going to a wholesale reinterpretation of the Constitution to grant these never-before-seen executive powers, and it's possible that he's right about that. We're not going to know that. There have been a couple of preliminary rulings that seem friendly to Trump, but none of those is final, so we can't really be sure of it.Dana MilbankMy guess is that Chief Justice Roberts is seeing his legacy heading toward the ditch after his decision of Trump v. United States, where he said that Presidents cannot be criminally prosecuted….My guess is he's going to unpleasantly surprise Trump in the coming months.Ralph NaderAlan Morrison is the Lerner Family Associate Dean for Public Interest & Public Service at George Washington Law School. He currently teaches civil procedure and constitutional law, and previously taught at Harvard, NYU, Stanford, Hawaii, and American University law schools. He has argued 20 cases in the Supreme Court and co-founded the Public Citizen Litigation Group in 1972, which he directed for more than 25 years.It's inevitable that even for a non-economist like myself to understand that [the costs of tariffs] are going to be passed on. Other than Donald Trump, I don't think there's anybody who believes that these taxes are not going to be passed on and that they're going to be borne by the country from which the company did the exporting.Alan MorrisonIt's an uphill battle on both the statutory interpretation and the undue delegation grounds, but our position is rather simple: If the Congress doesn't write a statute so that there's something that the government can't order or do, then it's gone too far. In effect, it has surrendered to the President its power to set policy and do the legislative function. Interestingly, Trump has trumpeted the breadth of what he's doing here. He calls it a revolution. Well, if we have revolutions in this country, my copy of the Constitution says that the Congress has to enact revolution and the President can't do it on its own. So we think we've got a pretty strong case if we can get it to court.Alan MorrisonOne of the things that I've been struck by is that laws alone cannot make this country governable. That we can't write laws to cover every situation and every quirk that any person has, especially the President. We depend on the norms of government—that people will do things not exactly the way everybody did them before, but along the same general lines, and that when we make change, we make them in moderation, because that's what the people expect. Trump has shed all norms.Alan MorrisonNews 4/9/251. Our top story this week is the killing of Omar Mohammed Rabea, an American citizen in Gaza. Known as Amer, the BBC reports the 14-year-old was shot by the Israeli military along with two other 14-year-old boys “on the outskirts of Turmus Ayya” on Sunday evening. Predictably, the IDF called these children “terrorists.” According to NJ.com – Rabea formerly resided in Saddle Brook, New Jersey – Rabea's uncle sits on the board of a local Palestinian American Community Center which told the press “The ambulance was not allowed to pass the checkpoint for 30 minutes, a denial in medical treatment that ultimately resulted in Amer's death…[his] death was entirely preventable and horrifically unjust. He was a child, a 14-year-old boy, with an entire life ahead of him.” The Rachel Corrie Foundation, founded in honor of the American peace activist killed by an Israeli bulldozer while protesting the demolition of a Palestinian home, issued a statement reading “Rabea's death…was perpetuated by Israeli settlers who act with impunity…We believe that if our own government demanded accountability…Rabea would still be alive.” The Council on American-Islamic Relations (CAIR) has sent a letter to Attorney General Bondi demanding an investigation, but chances of the Trump administration pursuing justice in this case are slim.2. Meanwhile, President Trump seems to be driving the U.S. economy into a deep recession. Following his much-publicized tariff announcement last week – which included 10% tariffs on uninhabited Heard and McDonald Islands – the S&P dipped by 10.5%, among the largest drops in history, per the New York Times. Far from making Trump back off however, he appears dead set on pushing this as far as it will go. After the People's Republic of China responded to the threat of a 54% tariff with a reciprocal 34% tariff, Trump announced the U.S. will retaliate by upping the tariff to a whopping 104% on Chinese imports, according to the BBC. Reuters reports that JP Morgan forecasts a 60% chance of a recession as a result of these tariffs.3. In more foreign affairs news, on Friday April 4th, South Korea's President Yoon Suk Yeol was officially removed from office by that country's Constitutional Court, “ending months of uncertainty and legal wrangling after he briefly declared martial law in December,” per CNN. The South Korean parliament had already voted to impeach Yoon in December of 2024. The court's decision was unanimous and characterized the leader's actions as a “grave betrayal of the people's trust.” Upon this ruling being handed down, Yoon was forced to immediately vacate the presidential residence. A new election is scheduled for June 3rd. Incredible what a political and judicial class unafraid to stand up to lawlessness can accomplish.4. Speaking of ineffectual opposition parties, one need look no further than Texas' 18th congressional district. This safe Democratic district – including most of central Houston – was held by Congresswoman Sheila Jackson Lee from 1995 until her death in 2024. According to the Texas Tribune, Lee planned to run yet again in 2024, triumphing over her 43-year-old former aide Amanda Edwards in the primary. However, Lee passed in July of 2024. Edwards again sought the nomination, but the Harris County Democratic Party instead opted for 69-year-old former Houston Mayor Sylvester Turner, per the Texas Tribune. Turner made it to March of 2025 before he too passed away. This seat now sits vacant – depriving the residents of central Houston of congressional representation and the Democrats of a vote in the House. Governor Gregg Abbot has announced that he will not allow a special election before November 2025, the Texas Tribune reports. This is a stunning Democratic own-goal and indicative of the literal death grip the gerontocratic old guard continue to have on the party.5. One ray of hope is that Democratic voters appear to be waking up the ineffectual nature of the party leadership. A new Data for Progress poll of the 2028 New York Senate primary posed a hypothetical matchup between incumbent Senator Chuck Schumer and Democratic Socialist firebrand Congresswoman Alexandria Ocasio-Cortez – and found AOC with a staggering lead of 19 points. This poll showed AOC winning voters under 45 by 50 points, over 45s by eight points, non-college educated by 16 points, college educated by 23 points, Black and white voters by 16 points, and Latinos by 28. Schumer led among self-described “Moderates” by 15 and no other group. It remains to be seen whether the congresswoman from Queens will challenge the Senate Minority Leader, but this poll clearly shows her popularity in the state of New York, and Schumer's abysmal reputation catching up with him.6. Another bright spot from New York, is Zohran Mamdani's mayoral candidacy and specifically his unprecedented field operation. According to the campaign, between April 1st and April 6th, volunteers knocked on 41,591 doors. No mayoral campaign in the history of the city has generated a grassroots movement of this intensity, with politicians traditionally relying on political machines or enormous war chests to carry them to victory. Mamdani has already reached the public financing campaign donation cap, so he can focus all of his time and energy on grassroots outreach. He remains the underdog against former Governor Andrew Cuomo, but his campaign appears stronger every day.7. Turning to the turmoil in the federal regulatory apparatus, POLITICO reports Secretary of Health and Human Services Robert F. Kennedy Jr. has eliminated the Freedom of Information Act offices at the Centers for Disease Control, and other HHS agencies. An anonymous source told the publication that HHS will consolidate its FOIA requests into one HHS-wide office, but “Next steps are still in flux.” In the meantime, there will be no one to fulfill FOIA requests at these agencies. This piece quotes Scott Amey, general counsel at the Project on Government Oversight, who said this “sends a wrong message to the public on the administration's commitment to transparency.” Amey added, “I often say that FOIA officers are like librarians in knowing the interactions of the agency…If you don't have FOIA officers with that specific knowledge, it will slow down the process tremendously.”8. At the Federal Trade Commission, Axios reports the Trump administration has “paused” the FTC's lawsuit against major pharmacy benefit managers, or PBMs, related to “the drug middlemen…inflating the price of insulin and driving up costs to diabetes patients.” The case, filed against CVS Caremark, OptumRx and Express Scripts was halted by the FTC in light of “the fact that there are currently no sitting Commissioners able to participate in this matter.” That is because Trump unlawfully fired the two remaining Democratic commissioners Alvaro Bedoya and Rebecca Slaughter. In a statement, former FTC Chair Lina Khan called this move “A gift to the PBMs.”9. One federal regulatory agency that seems to be at least trying to do their job is the Federal Aviation Administration. According to the American Prospect, the FAA has “[has] proposed [a] rule that would mandate Boeing update a critical communications malfunction in their 787 Dreamliner plane that could lead to disastrous accidents.” As this piece explains, “very high frequency (VHF) radio channels are transferring between the active and standby settings without flight crew input.” The FAA's recommendation in is that Boeing address the issue with an update to the radio software. Yet disturbingly, in one of the comments on this proposed rule Qatar Airways claims that, “[they have] already modified all affected…airplanes with … [the recommended software updates] …However … flight crew are still reporting similar issues.” This comment ends with Qatar Airways stating that they believe, “the unsafe condition still exists.” Boeing planes have been plagued by critical safety malfunctions in recent years, most notably the 2018 and 2019 crashes that killed nearly 350 people.10. Finally, on a somewhat lighter note, you may have heard about Bryan Johnson, the tech entrepreneur dubbed “The Man Who Wants to Live Forever.” Johnson has attracted substantial media attention for his unorthodox anti-aging methods, including regular transfusions of plasma from his own son. But this story is not about Johnson's bizarre immortality obsession, but rather his unsavory corporate practices. A new piece in New York Magazine focuses on the lawsuits filed against Johnson by his all-too-mortal workers, represented by eminent labor lawyer Matt Bruenig. This piece relays how Johnson “required his staffers to sign 20-page NDAs,” and an “opt-in” document which informed his employees they had to be comfortable “being around Johnson while he has very little clothing on” and “discussions for media production including erotica (for example, fan fiction including but not limited to story lines/ideas informed by the Twilight series and-or 50 Shades of Grey.)” Bruenig says, “That stuff is weird,” but his main interest is in the nondisparagement agreements, including the one Johnson's former employee and former fiancée Taylor Southern entered into which has further complicated an already thorny legal dispute between Johnson and herself. Now Bruenig is fighting for Southern and against these blanket nondisparagement agreements in a case that could help define the limits of employer's power to control their workers' speech. Hopefully, Bruenig will prevail in showing that Johnson, whatever his pretensions, truly is a mere mortal.This has been Francesco DeSantis, with In Case You Haven't Heard. Get full access to Ralph Nader Radio Hour at www.ralphnaderradiohour.com/subscribe