PBM Reform Podcast

By Pharmacy Podcast NetworkNews

PBM Reform Podcast episodes

December 15, 2025 U.S. Congressman Jake Auchincloss | PBM Reform with APCI
In this episode, Greg Reybold speaks with Jake Auchincloss, U.S. Congressman of Massachusetts 4th District.
42 min
December 12, 2025 Don't Get Paid Below Your Cost Anymore! | PBM Reform
This week on the PBM Reform Podcast, Breck L. Rice takes listeners inside a major new software upgrade designed to integrate directly with state-level PBM complaint and reporting systems. Breck also recounts his recent meetings with state Insurance Commissioners—where he presented this breakthrough technology while PBM lobbyists pushed back in real time, leaving community pharmacy with only one voice in the room standing up for them.
He underscores a critical issue that often goes unaddressed: while states continue to pass legislation aimed at PBM accountability, the real failures are happening in execution and enforcement. Without meaningful oversight, even the strongest laws fall short, and independent pharmacies continue to bear the consequences.
32 min
November 13, 2025 Cutting Through the Noise: A nuanced discussion on MFN, Rebates, and Premiums | PBM Reform with APCI
Dr. Robert Popovian is a pharmacist, and economist with a deep background in research and public policy. In this episode we have a nuanced discussion on policy impacting pharmacy including PBMs, President Trumps Most Favored Nation Executive Order, Rebates, and insurance premiums.

Links to resources referenced in discussion:

• Pioneer Institute, 340B tool: https://pioneerinstitute.org/340babuse/
• Pioneer Institute, IRA tool: https://pioneerinstitute.org/the-inflation-reduction-act-ira-overview/
• Editorial regarding TrumpRX: https://www.linkedin.com/pulse/promise-trumprx-robert-popovian-vskne/?trackingId=dtiG1P%2B%2BSDq6adLfFeEbeg%3D%3D
• Pioneer Institute, IRA report: https://pioneerinstitute.org/wp-content/uploads/Prescription-Drug-Price-Controls-06252025.pdf
• GHLF tool, Impact of Accumulators and Maximizers on Premiums: https://cutt.ly/Rr9Di7Vf
• Conquest Advisors website: https://conquestadvisors.godaddysites.com/
55 min
September 05, 2025 PBM Reform and the AMA | PBM Reform
In this episode, we sit down with the President of the American Medical Association to discuss PBM reform and its impact on patients, physicians, and the future of healthcare. From drug pricing transparency to ensuring access to needed medications, this conversation explores why PBM reform is at the center of today’s healthcare policy debates.
29 min
September 03, 2025 Behind the Policy: PBMs, Drug Pricing & Telehealth with Conor Sheehey | PBM Reform with APCI
Join our co-hosts Todd Eury and Greg Reybold in this exclusive interview with Conor Sheehey, who most recently served as senior health policy advisor to U.S. Senate Finance Committee Chair Mike Crapo (R-ID). In this role, he advised the Committee on a range of health care policy issues, including prescription drug pricing, telehealth, AI, provider coverage and reimbursement, fraud and abuse, medical devices, and Medicare Parts B and D. Sheehey led several bipartisan legislative efforts, including the development of comprehensive PBM reforms and bipartisan proposals on clinician payment reform and drug shortages.
57 min
June 19, 2025Cracking the Concentration: PBMs, Power, and the Fight for Fairness | PBM Reform with APCI
In this relaunch of the PBM Reform Podcast, Greg Reybold returns with a powerful and timely conversation exploring how concentrated economic power—particularly in the form of Pharmacy Benefit Managers (PBMs)—is undermining fair access to prescription medications, driving up drug costs, and crushing independent pharmacies.

Greg is joined by Emma Freer, Senior Policy Analyst with the American Economic Liberties Project, a national non-profit and non-partisan organization dedicated to dismantling monopolistic control across critical sectors—including healthcare. Together, they dig deep into how PBMs serve as gatekeepers in the drug supply chain, extracting value at the expense of patients and providers, and how policy reform is urgently needed.

Emma outlines how Economic Liberties is driving a new wave of anti-monopoly policy momentum in healthcare by advocating for stronger antitrust enforcement, corporate accountability, and legislative transparency. She highlights how concentrated PBM power not only threatens economic fairness but undermines public health outcomes.

🧠 Key Topics Covered:
The history and unchecked growth of PBM power in the U.S. drug supply chain

Why market concentration among PBMs is a systemic risk to patient access and competition

What Economic Liberties is doing to pressure regulators and lawmakers for structural reforms

Why bipartisan PBM reform is gaining traction—and what’s at stake if we fail to act

How pharmacists, community leaders, and patients can join the movement for transparency and equity

💥 Why This Episode Matters:
PBM dominance is no longer just a pharmacy issue—it’s an economic justice issue. This episode sheds light on the structural forces keeping drug prices high and independent pharmacies on the edge. It offers a compelling call to action for healthcare professionals, lawmakers, and reform advocates to push back against monopolistic control and put patients first.

📢 Call to Action:
Visit www.economicliberties.us to explore their policy work and toolkits for reform advocates. Stay tuned to the PBM Reform Podcast as we bring together voices from across the healthcare and policy spectrum to fight for a fairer, more transparent system.

Follow, rate, and share the podcast—because real reform starts with awareness and ends with action.
51 min
June 12, 2025 Certifying the Future: Dr. William Soliman and the Rise of Medical Affairs | PBM Reform
Dr. William Soliman is the founder and CEO of the Accreditation Council for Medical Affairs (ACMA). The ACMA is America’s leader in life sciences accreditation, certification & training. Soliman is a former pharmaceutical executive who worked in leadership roles at Merck, Abbvie, Gilead and more. He is considered a pharma industry futurist and has been featured on NewsNation, Fox News, Newsmax, Forbes, Al Jazeera, Yahoo Business TV, ABC News Radio & more. The ACMA established the first ever certification standards in the United States and stands as a benchmark of excellence for prior authorization professionals, reimbursement professionals, pharmaceutical sales professionals, medical science liaisons and medical affairs professionals. Dr. Soliman received his PhD from Columbia University & his BA from New York University.
47 min
April 15, 2025 PBM Transparency, Is It Real? | PBM Reform Podcast
An insider’s look at the games PBMs play to hid fees and tack profits for community pharmacies. What a true transparent PBM should look like and why it matters.
43 min
January 27, 2025 PBM Strategies for the State of Arizona | PBM Reform
Interview with the new CEO of the Arizona Pharmacy Association, Garet Turner
50 min
December 20, 2024Patients Before Monopolies Act | PBM Reform Podcast
In this critical episode of the PBM Reform Podcast, we are joined by two influential voices leading the charge against abusive pharmacy benefit manager (PBM) practices:
State Representative Jake Auchincloss – Congressman from Massachusetts’ Fourth District

Greg Reybold – Vice President of Healthcare Policy & General Counsel, American Pharmacy Cooperative, Inc.
Topics Discussed:
The "Pharmacists Fight Back Act" (HB 9096):
Legislation Overview:
The bill proposes a transparent pharmacy reimbursement model based on:
Market-based pricing benchmarked to the National Average Drug Acquisition Cost (NADAC) plus a dispensing fee equivalent to each state’s Medicaid reimbursement or the lesser of 2% or $25.
Eliminating PBMs’ ability to restrict patient choice through network exclusions.

Ensuring rebate pass-throughs to patients directly at the pharmacy counter.

Prohibiting PBM practices that steer patients toward PBM-owned pharmacies, protecting community pharmacists and preserving patient choice.

Guest insights on how HB 9096 seeks to end exploitative PBM tactics and its potential impact on independent pharmacies nationwide.

The "Patients Before Monopolies Act":
Bipartisan Efforts:
Introduced by Senators Elizabeth Warren (D-MA) and Josh Hawley (R-MO) to dismantle PBMs’ monopoly power.

Co-sponsored by Representatives Jake Auchincloss (D-MA) and Diana Harshbarger (R-TN).
Key Goals:
Break up PBM ownership structures that lead to conflicts of interest.
Ensure fair reimbursement practices for all pharmacies, reducing patient drug costs and increasing healthcare access.
Discussion on the broader implications for federal programs and the pharmacy industry at large.

PBMs and Their Role in Driving Up Drug Costs:
Exploring how PBMs contribute to higher drug prices and diminished patient choice.
The detrimental effects of PBM practices on independent community pharmacies and patients enrolled in federal healthcare plans.

Call to Action:
Contact your legislators to express support for the Pharmacists Fight Back Act (HB 9096) and the Patients Before Monopolies Act.
Share this episode to spread awareness of the critical need for PBM reform.
Resources & Links:
Learn more about HB 9096 and its provisions:
https://www.congress.gov/bill/118th-congress/house-bill/9096
Support the Patients Before Monopolies Act:
https://www.drugtopics.com/view/long-awaited-pbm-reform-included-in-congress-end-of-year-spending-package

References:
Intro piece: "Senators Warren and Hawley introduce a bipartisan bill to break up pharmacy-benefit managers" via CNBC Television
32 min

About PBM Reform Podcast

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Pharmacy benefit managers were created as middlemen to reduce administrative costs for insurers, validate a patient’s eligibility, administer plan benefits, and negotiate costs between pharmacies and…