PBM transparency problems are a huge issue that most people are unaware of. Pharmacy benefit managers (PBMs) are like a toll bridge between you and the price you pay for medication. Find out how PBMs affect drug costs and influence the drugs covered by your insurance, all for their own financial gain.
0:00 Introduction: Do PBMs raise drug costs?
0:45 Hidden PBM fees explained
1:39 Spread pricing explained
3:49 How PBMs affect insurance premiums
4:30 Raising awareness about hidden PBM fees
Grass-fed scam video: ▶️ https://youtu.be/fgYcVR7YBBQ
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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.
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Disclaimer:
Dr. Eric Berg received his Doctor of Chiropractic degree from Palmer College of Chiropractic in 1988. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Berg is a licensed chiropractor in Virginia, California, and Louisiana, but he no longer practices chiropractic in any state and does not see patients, so he can focus on educating people as a full-time activity, yet he maintains an active license. This video is for general informational purposes only. It should not be used to self-diagnose, and it is not a substitute for a medical exam, cure, treatment, diagnosis, prescription, or recommendation. It does not create a doctor-patient relationship between Dr. Berg and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition.
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Thanks for watching! I hope this increases your awareness about PBMs and drug price inflation. I’ll see you in the next video.
