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In this episode:

Are pharmacy benefits actually helping employers and employees—or has the system become a costly black box?

Jim Stroud sits down with Alan Pannier, Chief Strategy Officer at SmithRx, to unpack how the U.S. pharmacy benefit ecosystem really works and why it can feel “scammy” even when it’s legal. Alan explains how PBMs were originally built to simplify pharmacy access, and how the model evolved into opaque pricing practices that can drive costs higher.

In this episode, we break down spread pricing, rebate incentives, and why the “middle layer” of healthcare may be the biggest winner when no one can see the real numbers. Jim also presses for practical guidance: what HR leaders should ask their PBM, how to evaluate vendors using net cost vs. discount math, and what “fiduciary alignment” should look like in a contract.

If you’re an employer, HR leader, or benefits decision-maker wondering why drug costs keep climbing—and what you can do about it—this conversation is your cheat sheet.

Contact our guest:

Alan Pannier - https://www.linkedin.com/in/alan-pannier

SmithRx - http://www.smithrx.com/