Episode 93 - Unpacking PBMs with Benjamin Jolley, PharmD

Welcome to an insightful episode of CPhT Connect, the podcast for Pharmacy Technicians! Join hosts Mike Johnston and Ashleigh Smith as they engage in a compelling discussion with Dr. Benjamin Jolley about the complexities of Pharmacy Benefit Managers (PBMs) and their impact on independent pharmacies.

In this episode, Dr. Jolley defends the existence of PBMs in managing insurance payments but critiques the inherent conflicts of interest when PBMs also operate as pharmacies. He explains how this dual role can lead to unethical practices, such as steering patients toward their affiliated pharmacies and imposing burdensome audits predominantly on independent pharmacies. Notably, Dr. Jolley references a revealing audit by the Mississippi Board of Pharmacy, which found that most OptumRx audits targeted independents, raising questions about fairness and transparency.

Listeners will gain insight into the historical context of PBMs, the complexities of pharmacy pricing, and legislative efforts like the Patients Before Monopolies Act to address these issues. Dr. Jolley also highlights the importance of community engagement in advocating for fairer practices in the pharmacy industry.

Don’t miss this enlightening episode filled with expert analysis, real-world examples, and actionable insights. Tune in now to learn more about the evolving landscape of pharmacy benefits and the crucial steps needed to support independent pharmacies. Connect with Dr. Jolley on LinkedIn and Substack for more thought-provoking content, and stay tuned for upcoming episodes that explore the diverse challenges and opportunities in the pharmacy profession.