Heads Up Adviser

The Advisor’s PBM Playbook: How to Win on Lowest Net Cost, Not Spreadsheets

Episode Summary

In this eye-opening episode, John Sbrocco sits down with Justin Jasniewski, CEO of Serve You RX, to expose the hidden tricks and misaligned incentives within the PBM industry. They reveal why the introduction of Humira biosimilars failed to lower costs and how PBMs use tactics like “product hopping” to keep employers paying top dollar for specialty drugs.

Episode Notes

Justin, a PBM industry insider, pulls back the curtain on the complex games that drive up pharmacy spend. He explains the critical difference between a PBM that claims to be “transparent” and one that is a true fiduciary, contractually bound to act in your best interest. This conversation moves beyond the misleading “spreadsheet game” of chasing rebates to focus on the one metric that actually matters: lowest net cost.

Tune in to understand:

• The key questions you must ask to determine if your PBM is truly aligned with your plan.
• Why the highest rebate almost never equals the lowest cost.
• The “product hopping” tactic that’s costing your health plan millions on specialty drugs.
• How to leverage your own data and focus on PMPM (per member per month) spend to achieve real, measurable savings.

LEARN MORE
Serve You RX: https://serveyourx.com/
Heads Up Adviser: https://virtuealliance.com/heads-up-adviser/
Show Sponsor Virtue Health: https://virtuealliance.com/

CONNECT ON LINKEDIN
Justin Jasniewski: https://www.linkedin.com/in/justin-jasniewski/
John W. Sbrocco: https://www.linkedin.com/in/johnwsbrocco/