In this episode of Disruption/Interruption, host KJ interviews Mark Mincy, Chief Commercial Officer at US RX Care, about the hidden complexities and conflicts of interest in the pharmacy benefits industry. Mark shares how his company is disrupting the status quo by demanding transparency, eliminating conflicts, and helping employers reclaim millions in savings. The conversation uncovers the tangled web of PBMs, rebates, and the urgent need for legislative and technological change.

Key Takeaways:

1. The PBM System is Riddled with Conflicts of Interest [2:34]
   Mark explains how pharmacy benefit managers (PBMs) and consultants often act in their own financial interest, not the employer’s or patient’s, leading to inflated drug costs.
2. Rebates and Purchasing Contributions Inflate Drug Prices [8:59]
   The system of rebates and retrospective payments to PBMs can account for up to 80% of a drug’s cost, forcing manufacturers to raise prices and employers to pay more.
3. Transparency and Fiduciary Duty are Essential for Reform [21:37]
   Mark’s company, US RX Care, operates with complete transparency, passes back all rebates, and offers per-member-per-month guarantees to eliminate guesswork and conflicts.
4. Employers and Consumers Can Take Action [33:34]
   Mark recommends joining healthcare purchaser coalitions, hiring ERISA attorneys, and demanding non-conflicted consultants to protect interests and drive industry change.

Quote of the Show [31:27]:
"Everything's intertwined. You want to move and do the right thing. These employers are between a rock and a hard place, so I do think some legislative action needs to occur." – Mark Mincy

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Ways to connect with Mark Mincy:

LinkedIn: http://www.linkedin.com/in/mark-mincy-a185497

Company Website: https://us-rxcare.com

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