For the first episode of Risky Business with Brett, I sit down with Jay Gulley of Leadway Rx to pull back the curtain on one of the most complicated and misunderstood pieces of an employer’s health plan: pharmacy benefits.

Jay brings a perspective you don't always hear in the PBM conversation. He comes from the pharmacy side of the business and has seen firsthand how decisions made throughout the prescription drug supply chain affect pharmacists, employers, health plans, and ultimately the people paying for their medications.

We get into rebates, specialty drugs, GLP-1s, biosimilars, J-code and infusion drugs, vertical integration, GPOs, PBM legislation, and some of the incentives buried inside a system that most employers rarely get to see.

But this isn't just a conversation about what's wrong with pharmacy benefits. It's about understanding how the system actually works, where the money goes, and what employers should be asking about their own plans.

No sales pitch. No pretending the answers are simple. Just a conversation about an incredibly complicated business that deserves a little more transparency.

Come take a look behind the curtain.