In Episode 3 of Captivating Health Insights, host Maddison Bezdicek continued her conversation with Kevin Kobielski, President and Founder of Navion, to unpack the more technical—and often overlooked—aspects of pharmacy benefit manager (PBM) selection: contract design, audit enforcement, savings strategies, and emerging market trends.
Building on Part 1’s discussion of PBM models and cost drivers, Part 2 focused on execution—how audit rights, market checks, and contract language can materially affect plan performance. Kobielski explained that rebate guarantees and discount terms may appear attractive, but exclusions and fine-print “optics” often undermine their value.
The episode also explored alternative drug procurement strategies, including Cost Plus Drugs, 340B programs, and manufacturer assistance plans. Kobielski emphasized that to make these strategies work, employers must implement effective incentives and “solution stack” multiple vendors to drive adoption and savings.
Kobielski noted employers should prepare for increased regulation to boost transparency and limit vertical integration. He also stressed the importance of tools measuring financial outcomes and clinical impact.
Key takeaway:
Contracts are the linchpin of PBM performance. Employers that scrutinize fine print, enforce audit rights, and embrace flexible, layered solutions are best positioned to manage pharmacy costs and care.
Listen and subscribe on your favorite platforms, including YouTube, Apple, Spotify, Amazon Music, iHeartRadio, Pandora, and Pocket Casts, to learn more about GLP-1s and how healthcare providers and employers can collaborate to deliver better, longer-lasting results.
