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Pharmacy Benefit Managers: The American Drug Cartel.

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In this episode, Max breaks down the biggest scandal in the healthcare industry (and that’s saying a lot). We walk through how a bunch of pencil pushing pharmacy middlemen became so powerful they bought out the biggest health insurance companies and pharmacy chains, and did it through hiking up drug prices, kickbacks and taking advantage of government contracts. This is the story of pharmacy benefit managers (PBMs) and how they became the American Drug Cartel.


Intro: 00:00:36

Sponsors: 00:03:14

Chapter One: The Birth of the American Drug Mafia. 00:04:47

Chapter Two: Unraveling the Supply Chain. 00:16:15

Chapter Three: Is that all? Please tell me that’s all. 00:28:09

Chapter Four: Bring it home, Max. 00:38:44

Post Show Musings: 00:45:24

Outro: 00:01:16


NAIC: Pharmacy Benefit Managers

Healthcare Dive: FTC launches investigation into PBMs; CVS, UnitedHealth, Cigna and more hit with requests for data

FTC: FTC Launches Inquiry Into Prescription Drug Middlemen Industry

Healthcare Dive: PBM practices are keeping consumers from generics savings, white paper finds

Association for Accessible Medicines:  US Generic and Biosimilar Medicines Savings Report 2021

Lever News: Who’s Killing Your Independent Pharmacy?


USC: PBMs Are Inflating the Cost of Generic Drugs. They Must Be Reined In

Jama Network: Costco v Medicare study 

Frier Levitt: AUDITING PBMs


National Bureau of Economic Research: CVS Response: A world without PBMs: Unpacking the data

FTC: White House Roundtable PBMs

Yahoo Finance: 30 Largest Companies by Revenue

UNFTR Episode Resources

Healthcare Series.


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Unf*cking the Republic® is produced by 99 and engineered by Manny Faces Media (mannyfacesmedia.com). Original music is by Tom McGovern (tommcgovern.com) and Hold Fast (holdfastband.com). The show is written and hosted by Max and distributed by 99.

Podcast art description: Image of the US Constitution ripped in the middle revealing white text on a blue background that says, "Unf*cking the Republic®."

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Unf*cking The Republic® (UNFTR)

Unf*cking The Republic® (UNFTR) is a series of audio essays on the grand American experiment lovingl 
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