In Episode 2 of Captivating Health Insights—and Part 1 of a two-part conversation—host Maddison Bezdicek sat down with Kevin Kobielski, President and Founder of Navion, to unpack one of the most consequential decisions facing self-funded employers today: choosing the right pharmacy benefit manager (PBM).
Drawing on more than a decade of pharmacy consulting experience, Kobielski offered an insider’s perspective on the rising costs of pharmacy benefits—now accounting for over 50% of total healthcare spend—and why the PBM selection process can make or break plan performance. This episode covered the key factors influencing PBM effectiveness, from transparency and rebates to formulary structure and specialty drug management.
Kobielski highlighted the differences between traditional and transparent PBM models and urged employers to look past buzzwords. The absolute priority, he argued, is aligning incentives and maintaining auditability. “You want strong pricing,” he noted, “but also the flexibility to bolt on programs that manage clinical trends without compromising care.”
Listeners will also gain clarity on specialty pharmacy, biosimilars, and why some employers are turning to international sourcing or manufacturer assistance programs to manage runaway drug costs.
Key takeaway:
Choosing a PBM isn’t about finding the “best” model—it’s about finding the right fit for your organization’s size, goals, and risk tolerance. Strong financial terms, clinical oversight, and program flexibility are essential to managing cost and care.
Listen to Part 2 of Bezdicek's conversation with Kevin for more key takeaways.
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