How PBMs Pull a Fast One on Even The Savviest of Business Minds

Exceptionally smart and talented people make the health benefit decisions for their Fortune 500 corporations, but it continues to surprise us how very few ever think to push back against the multitudes of underhanded PBM practices regularly reported in the business media.  Unfortunately, despite evidence to the contrary, it seems the decision-makers in these super successful companies are buying into the rhetoric, absolutely confident they got the “best deal” and have the “best discounts”.

These are real-life comments from people who refuse to believe PBMs and the brokers who control the bidding would ever manipulate the RFP process and from corporate decision-makers who are in over their heads or can’t keep up with all of the antics of the ‘PBMafia’.  

McKesson Corporation is a Fortune 10 healthcare company and even they were fooled.  Purely by accident, it was uncovered that McKesson’s self-insured employee medical plan was utilizing prescription benefits administered by CVS/Caremark that disadvantaged McKesson’s own customers.  McKesson owns a PSAO (an entity that signs the required PBM contracts for independent pharmacies), they have independent pharmacies as customers, and they completely missed the unethical tactic that was allowing CVS/Caremark to pay themselves and all other large chains substantially more than their small chain and independent pharmacy customers. 

Around 6 weeks after the discrepancy was uncovered, miraculously, all McKesson customers began to be paid on par with their large chain counterparts. McKesson Corporation has never officially commented on the issue, but a fundamental change clearly happened. It’s a prime example of how the PBM machine uses every avenue possible to cheat the corporate customers they’re supposed protect, even ones in the healthcare industry. 

You may be wondering how can this happen.  How can employers, even those in healthcare, be so financially exploited? How do PBMs have so much power that they can readily extract so much money from the system? 

Take a look at these contracts from a PBM obtained from local government entities.  Contracts like these are just one of the many power plays PBMs employ. One look and you can see they’re one-sided. What do YOU think? Share your insights & comments with us!

​To view the redacted contracts discussed in this article, click Here