Classic conflict of interest. Let’s talk incentives. Pharmacies, insurers, and PBMs (pharmacy benefit managers) are in a tangled drug pricing system. PBMs get

Classic conflict of interest. Let’s talk incentives. Pharmacies, insurers, and PBMs (pharmacy benefit managers) are in a tangled drug pricing system. PBMs get rebates from drugmakers for pushing their drugs, but when the PBM and insurer are part of the same company, things get questionable. Suddenly, there’s a clear incentive to favor expensive drugs with bigger rebates, even when cheaper alternatives would work just as well. You’re stuck paying a higher copay and, next year, likely higher premiums too—because, wow, these drugs are pricey! Meanwhile, the insurer isn’t concerned. They’re not covering the full cost of the drug or your copay, and they’re pocketing the rebate. The system works—just not for you.