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.

Chapters

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

Resources

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?

PSSNY: PBM Basics

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

Jama Network: Costco v Medicare study 

Frier Levitt: AUDITING PBMs

46Brooklyn

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.

--

If you like the pod version of #UNFTR, make sure to check out the video version on YouTube where Max shows his beautiful face! www.youtube.com/@UNFTR

Please leave us a rating and review on Apple Podcasts: unftr.com/rate and follow us on Facebook, Twitter and Instagram at @UNFTRpod. Visit us online at unftr.com.

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Check out the UNFTR Pod Love playlist on Spotify: spoti.fi/3yzIlUP.

Visit our bookshop.org page at bookshop.org/shop/UNFTRpod to find the full UNFTR book list, and find book recommendations from our Unf*ckers at bookshop.org/lists/unf-cker-book-recommendations.

Access the UNFTR Musicless feed by following the instructions at unftr.com/accessibility.

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®."

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.
Chapters
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
Resources
NAIC: <a href="https://content.naic.org/cipr-topics/pharmacy-benefit-managers">Pharmacy Benefit Managers</a>
Healthcare Dive: <a href="https://www.healthcaredive.com/news/ftc-launches-investigation-into-pbms-cvs-unitedhealth-cigna-and-more-hit/625058/">FTC launches investigation into PBMs; CVS, UnitedHealth, Cigna and more hit with requests for data</a>
FTC: <a href="https://www.ftc.gov/news-events/news/press-releases/2022/06/ftc-launches-inquiry-prescription-drug-middlemen-industry">FTC Launches Inquiry Into Prescription Drug Middlemen Industry</a>
Healthcare Dive: <a href="https://www.healthcaredive.com/news/pbm-practices-consumers-generics-savings-USC/624702/">PBM practices are keeping consumers from generics savings, white paper finds</a>
Association for Accessible Medicines:  <a href="https://accessiblemeds.org/sites/default/files/2021-10/AAM-2021-US-Generic-Biosimilar-Medicines-Savings-Report-web.pdf">US Generic and Biosimilar Medicines Savings Report 2021</a>
Lever News: <a href="https://www.levernews.com/whos-killing-your-independent-pharmacy/">Who’s Killing Your Independent Pharmacy?</a>
PSSNY: <a href="https://www.pssny.org/page/PBMBasics">PBM Basics</a>
USC: <a href="https://healthpolicy.usc.edu/article/pbms-are-inflating-the-cost-of-generic-drugs-they-must-be-reined-in/">PBMs Are Inflating the Cost of Generic Drugs. They Must Be Reined In</a>
Jama Network: <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2781810?guestAccessKey=89d9de51-fc11-4451-97aa-90b352b7867b">Costco v Medicare study </a>
Frier Levitt: <a href="https://www.frierlevitt.com/what-we-do/pharmacy-law/defense-pbm-audits/">AUDITING PBMs</a>
<a href="https://www.46brooklyn.com/">46Brooklyn</a>
National Bureau of Economic Research: <a href="https://www.nber.org/papers/w30231">CVS Response: A world without PBMs: Unpacking the data</a>
FTC:<a href="https://www.ftc.gov/system/files/ftc_gov/pdf/2024.03.04-chair-khan-remarks-at-the-white-house-roundtable-on-pbms.pdf"> White House Roundtable PBMs</a>
Yahoo Finance: <a href="https://finance.yahoo.com/news/top-30-largest-us-companies-134902253.html">30 Largest Companies by Revenue</a>
UNFTR Episode Resources
<a href="https://www.unftr.com/unftr-series/healthcare">Healthcare Series.</a>
--
If you like the pod version of #UNFTR, make sure to check out the video version on YouTube where Max shows his beautiful face! <a href="https://www.youtube.com/@UNFTR">www.youtube.com/@UNFTR</a>
Please leave us a rating and review on Apple Podcasts: <a href="https://unftr.com/rate">unftr.com/rate</a> and follow us on <a href="https://www.facebook.com/Unfucking-The-Republic-102319714930389">Facebook</a>, <a href="https://twitter.com/unftrpod">Twitter</a> and <a href="https://www.instagram.com/unftrpod/">Instagram</a> at @UNFTRpod. Visit us online at <a href="https://www.unftr.com/">unftr.com</a>.
Join the Unf*cker-run Facebook group: <a href="https://www.facebook.com/groups/2051537518349565">facebook.com/groups/2051537518349565</a>
Buy yourself some Unf*cking Coffee® at <a href="https://shop.unftr.com/">shop.unftr.com</a>.
Subscribe to Unf*cking The Republic® at <a href="https://www.unftr.com/blog#subscribe">unftr.com/blog</a> to get the essays these episode are framed around sent to your inbox every week.
Check out the UNFTR Pod Love playlist on Spotify: <a href="https://open.spotify.com/playlist/1PpzNXBub9FLngMradJByC?si=abaed3d396504fae">spoti.fi/3yzIlUP.</a>
Visit our bookshop.org page at <a href="https://bookshop.org/shop/UNFTRpod">bookshop.org/shop/UNFTRpod</a> to find the full UNFTR book list, and find book recommendations from our Unf*ckers at<a href="https://bookshop.org/lists/unf-cker-book-recommendations"> bookshop.org/lists/unf-cker-book-recommendations</a>.
Access the UNFTR Musicless feed by following the instructions at <a href="https://www.unftr.com/accessibility">unftr.com/accessibility</a>.
Unf*cking the Republic® is produced by 99 and engineered by Manny Faces Media (<a href="https://www.mannyfacesmedia.com">mannyfacesmedia.com</a>). Original music is by Tom McGovern (<a href="http://www.tommcgovern.com/">tommcgovern.com</a>) and Hold Fast (<a href="https://holdfastband.com/">holdfastband.com</a>). 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®."

Unf*cking The Republic® (UNFTR) is a series of audio essays on the grand American experiment lovingly curated and presented by a quasi-anonymous political writer. 

Each essay reflects on a singular topic that is generally misunderstood or purposely obfuscated by the so-called “powers that be.” As we know, history is written by the victors and can be perilously manufactured to favor destructive world views. These views become intractably ingrained in the public consciousness and pervert public policy, oftentimes with horrific results. 

As of this podcast’s founding, we find ourselves living in a true kakistocracy. The disconnect between what we believe and what is actually happening below the surface or in plain sight is where this podcast lives. 

Together we’ll upend conventional wisdom, blow up narratives on the left, right and center and use magical devices like facts, logic and reason to explain how exactly we arrived in bizarro America, the funhouse mirror version of what was originally intended. #UNFTR

Unf*cking The Republic® (UNFTR) is a series of audio essays on the grand American experiment lovingly curated and presented by a quasi-anonymous political writer. 
Each essay reflects on a singular topic that is generally misunderstood or purposely obfuscated by the so-called “powers that be.” As we know, history is written by the victors and can be perilously manufactured to favor destructive world views. These views become intractably ingrained in the public consciousness and pervert public policy, oftentimes with horrific results. 
As of this podcast’s founding, we find ourselves living in a true kakistocracy. The disconnect between what we believe and what is actually happening below the surface or in plain sight is where this podcast lives. 
Together we’ll upend conventional wisdom, blow up narratives on the left, right and center and use magical devices like facts, logic and reason to explain how exactly we arrived in bizarro America, the funhouse mirror version of what was originally intended. #UNFTR

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