Telemedicine Talks

#21 - PBM Reforms Unpacked: How Drug Pricing Changes Impact Telemedicine


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Dr. Leo Damasco and Phoebe Gutierrez analyze the latest executive orders addressing pharmacy benefit managers (PBMs) and drug pricing reforms. They unpack the role of PBMs in controlling prescription drug costs, the hidden rebate system, and how these reforms aim to increase transparency and lower costs for patients. With a focus on telemedicine, they discuss how these changes could improve medication affordability, enhance prescribing flexibility, and impact the operations of telemedicine startups and providers. From ending rebate games to tying U.S. drug prices to international benchmarks, this episode offers critical insights for physicians navigating the evolving healthcare landscape.

Three Actionable Takeaways  

  • Monitor Formulary Changes – Stay updated on PBM formulary lists to ensure prescribed medications are covered, helping patients avoid high out-of-pocket costs and improving telemedicine prescribing efficiency.  
  • Advocate for Transparency – Support efforts to require PBMs to disclose rebates and pricing structures to ensure discounts are passed to patients, enhancing affordability in telemedicine workflows.  
  • Adapt Telemedicine Practices – Prepare for potential shifts in drug pricing and PBM regulations by aligning with compliant health plans and pharmacies to streamline prescription processes and improve patient outcomes.

About the Show

Telemedicine Talks explores the dynamic world of digital health, offering physicians insights into regulatory changes, compliance, and opportunities in telemedicine to enhance their practice and career.  

About the Hosts  

Dr. Leo Damasco – Pediatrician and emergency medicine physician turned telemedicine advocate, guiding doctors through the transition to virtual care.  

Phoebe Gutierrez – Former state regulator and telehealth executive, specializing in compliance and sustainable virtual care models.

Connect with Phoebe Gutierrez  

LinkedIn: https://www.linkedin.com/in/pkgutierrez/  

Email: [email protected] (mailto:[email protected])

The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with.


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Telemedicine TalksBy Phoebe Gutierrez, Dr. Leo Damasco, Doctor Podcast Network