Episode 6 — Greg Baker (AffirmedRx): The Rebate Shell Game and a Different Kind of PBM

Hannah Mamuszka and Lena Chaihorsky interview Greg Baker, founder and CEO of AffirmedRx, a pharmacy benefit manager structured as a public benefit corporation which was recently named No.5 on the Inc. 5000. Baker, a pharmacist who spent years running on-site pharmacies for large employers, argues the drug-pricing system isn't broken but "working as designed" to maximize shareholder profit. He explains how the dominant PBMs make money as a percentage of drug cost, creating an incentive to favor expensive, highly rebated brands over cheaper generics, and how manufacturers must compete on rebate size for formulary placement, using Humira and Enbrel as his example. He describes what he calls a rebate "shell game," in which PBMs route rebates ...