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PBMs, Insulin, And The Broken System Keeping Prices High with George Huntley
Show Notes
If you have ever stared at your pharmacy receipt and thought, How is this even legal? this episode is for you. George Huntley has lived with type 1 diabetes since 1983, spent 25+ years running employer health plans, and now sits at the center of national advocacy work on insulin access and drug pricing.
In this conversation, George breaks down how pharmacy benefit managers PBMs quietly took over drug pricing, why insulin became the poster child for a broken system, and how rebates turned into a giant, legal kickback loop that almost nobody at the patient level understands. We talk about why insurance started feeling so much worse in the 2010s, how PBMs profit when list prices go up, and why the health plan can actually pay less for insulin while you pay more at the counter.
George also walks through what actually happens behind the scenes when your employer picks a health plan, why most employers have no idea how much money is flowing to PBMs, and why the drugs on your formulary are often chosen for maximum rebate, not lowest cost or best fit. We finish with a rapid-fire True or False round that exposes some of the most harmful myths about PBMs, insulin list prices, and whether transparency alone could fix this mess.
What You Can Do Today
- Learn the vocabulary PBM, rebate, formulary so you can ask sharper questions of your HR team, benefits broker, or insurer.
- If you work for an employer that offers health insurance, ask whether they know their PBM spread and rebate structure, and if they’ve ever audited it.
- Share this episode with one person who helps make benefits decisions at work, or with someone in your T1D circle who has been crushed by insulin costs and needs language for what they’re experiencing.
Resources
Helpful resources and newsletter:
https://yourbestt1dyear.com
Sponsor Connect
Blue Circle Health offers free coaching and care that fits real life for adults with type 1 diabetes. They help with insulin adjustments, CGMs, burnout, and the mental load of diabetes, without fighting the healthcare system alone.
Sign up free at:
https://bluecirclehealth.org
Connect
TikTok: https://tiktok.com/@the.betes
Instagram: https://instagram.com/thebetes
Facebook: https://facebook.com/neilgreathouse
LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912
Website: https://yourbestt1dyear.com
Books on Amazon
Type 1 Diabetes – One Day at a Time
https://a.co/d/6UHooWJ
Type 1 Diabetes – True Stories
https://a.co/d/dfIlyI1
View all episodes
By Neil Greathouse
4.8
1616 ratings
Show Notes
If you have ever stared at your pharmacy receipt and thought, How is this even legal? this episode is for you. George Huntley has lived with type 1 diabetes since 1983, spent 25+ years running employer health plans, and now sits at the center of national advocacy work on insulin access and drug pricing.
In this conversation, George breaks down how pharmacy benefit managers PBMs quietly took over drug pricing, why insulin became the poster child for a broken system, and how rebates turned into a giant, legal kickback loop that almost nobody at the patient level understands. We talk about why insurance started feeling so much worse in the 2010s, how PBMs profit when list prices go up, and why the health plan can actually pay less for insulin while you pay more at the counter.
George also walks through what actually happens behind the scenes when your employer picks a health plan, why most employers have no idea how much money is flowing to PBMs, and why the drugs on your formulary are often chosen for maximum rebate, not lowest cost or best fit. We finish with a rapid-fire True or False round that exposes some of the most harmful myths about PBMs, insulin list prices, and whether transparency alone could fix this mess.
What You Can Do Today
- Learn the vocabulary PBM, rebate, formulary so you can ask sharper questions of your HR team, benefits broker, or insurer.
- If you work for an employer that offers health insurance, ask whether they know their PBM spread and rebate structure, and if they’ve ever audited it.
- Share this episode with one person who helps make benefits decisions at work, or with someone in your T1D circle who has been crushed by insulin costs and needs language for what they’re experiencing.
Resources
Helpful resources and newsletter:
https://yourbestt1dyear.com
Sponsor Connect
Blue Circle Health offers free coaching and care that fits real life for adults with type 1 diabetes. They help with insulin adjustments, CGMs, burnout, and the mental load of diabetes, without fighting the healthcare system alone.
Sign up free at:
https://bluecirclehealth.org
Connect
TikTok: https://tiktok.com/@the.betes
Instagram: https://instagram.com/thebetes
Facebook: https://facebook.com/neilgreathouse
LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912
Website: https://yourbestt1dyear.com
Books on Amazon
Type 1 Diabetes – One Day at a Time
https://a.co/d/6UHooWJ
Type 1 Diabetes – True Stories
https://a.co/d/dfIlyI1
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