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The PBM Problem Exposed: Why 1–3% of Members Drive 60% of Costs In this recap episode, host Lester Morales breaks down the powerful conversation with Rachel Strauss — widely known as the “PBM Princess” and one of the clearest, boldest voices exposing how pharmacy benefit managers (PBMs) really work.
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Time: 14:46
In this recap episode, host Lester Morales breaks down the powerful conversation with Rachel Strauss — widely known as the “PBM Princess” and one of the clearest, boldest voices exposing how pharmacy benefit managers (PBMs) really work.
Rachel spent much of her career inside a leading PBM that didn’t play the traditional rebate and spread-pricing games. Today, she’s on a mission to educate employers, advisors, and everyday consumers on the hidden mechanics of drug pricing — and why most people have no idea what they’re actually paying for.
In this recap, Lester dives into:
The emotional, financial, and human cost of a broken pharmacy system
How PBMs actually make money (and why the incentives are completely misaligned)
Why a $10 copay tells you nothing about the true price of a drug
The spread-pricing “black box” and how it hurts patients, employers, and local pharmacies
The shocking reality: 1–3% of plan members drive up to 60% of total pharmacy spend
Why employers can reduce costs by 50–70% on high-cost drugs using modern, patient-first strategies
The false belief that “employees won’t understand change” — and how it delays real solutions
Real-world paths to get the exact same medication for employees at zero cost
Rachel and Lester outline a simple but powerful truth: If the PBM profits when drug prices stay high, the game will never change.
This episode is a must-listen for employers, advisors, CFOs, HR leaders, and anyone who wants to understand why pharmacy costs are exploding — and what to do about it.
👉 Listen to the full conversation with Rachel Strauss in the main episode.
GUID: 7a4ab112-a6f6-478f-855d-36a7eda63bdc
Release Date: 24/12/2025, 15:37:00
