Media

In this episode, we dive into the hidden practices of PBMs with Shane Garduno, Vice President of PBM Practice at Xevant. Shane reveals insights into how employers can gain transparency and control prescription drug costs. Learn more about Xevant’s solutions at Xevant.com.

Brandon Newman, the founder and CEO of Xevant, emphasizes the importance of balanced regulation and transparency in the pharmacy industry. He cautions that proposed legislation could stifle competition and innovation if not carefully crafted, potentially leading to big PBMs exiting certain contracts. Newman argues that simply setting prices through government mandates does not necessarily achieve the desired outcomes, as manufacturers may raise prices elsewhere to compensate. Instead, he advocates for incentivizing positive behaviors and providing stakeholders, including pharmacists and pharmacies, with real-time access to claims data, rebates, and cost-saving opportunities.

The pharmaceutical benefits sector is notoriously complex yet pivotal in providing accessible and effective healthcare for millions. Characterized by a vast network of drug manufacturers, insurers, pharmacies, and patients, this intricate ecosystem comes with an overwhelming myriad of variables. Often resulting in opaque pricing structures, burdensome administrative processes, and inflated consumer costs, making it a significant challenge for healthcare providers and patients alike.

Brandon Newman, founder and CEO of Xevant, delves into the complex landscape of pharmacy benefits managers (PBMs) and the regulatory environment surrounding the industry. Newman highlights the outsized influence of the “big 3” PBMs, which control over 80% of pharmacy utilization, and how their practices impact the cost and access for both patients and pharmacies. He discusses the key legislative efforts at the state and federal levels, focusing on the push for greater transparency in reimbursement rates, business practices, and fees. He also emphasizes the role of innovative, smaller PBMs in offering unique value propositions, such as high-service models and a focus on overall therapy costs, as a counterbalance to the market dominance of the larger players.

Everyone says they want more affordable drugs for patients that need them, but people disagree quite a bit on who’s to blame for the current status quo of sky-high prescription prices – not to mention how they might be corrected.
To help unpack some of those trends and conflicting perspectives, Brandon Newman, CEO of healthcare analytics firm Xevant, joins host Jonah Comstock on today’s episode of the pharmaphorum podcast. They discuss the oft-maligned role of pharmacy benefit managers, problems with the drug pricing provisions in the Inflation Reduction Act, the lack of (and importance of) price transparency, the various levers available to the government to address prices, and what companies like Xevant are doing right now to lower drug prices for patients.

Healthcare expenses have surged to unprecedented levels, a trend highlighted by the fact that over 900 prescription medications experienced price hikes in January alone. This occurs as legislative entities grapple with the intricate details of formulating effective drug pricing policies. Amid these challenges, there are emerging signs of innovative solutions making a difference. One notable example is Xevant, a platform specializing in pharmaceutical analytics, which stands as a beacon of how technology and forward-thinking can contribute to making healthcare more accessible and affordable for the American population. Xevant is not merely participating in discussions about securing cost-effective medications; it is at the forefront of this movement.

Healthcare costs are record-high, evidenced by the fact that over 900 prescription drugs saw price increases in January alone. Meanwhile, legislative bodies are struggling to address the complexities of drug pricing legislation. Amid these challenges, innovation is starting to show promising signs. Xevant, a pharmaceutical analytics platform, is a testament to what technology and vision can achieve in pursuit of making healthcare more affordable for all Americans. With its sophisticated platform, Xevant is not just part of the conversation about achieving the lowest net-cost drugs; it is leading the charge.