The Pharmacy Benefit with JC Scott is a podcast series from the Pharmaceutical Care Management Association. This podcast highlights the PBM industry and the value PBMs bring to tens or millions of people throughout the country. PCMA President & CEO JC Scott explores and discusses a wide variety of topics with experts and industry leaders.

JC Scott talks with Julie Goon, Senior Vice President of Public Affairs for Anthem, Inc., and Tim Dube, PCMA’s Vice President of Regulatory Affairs. Together, they discuss good versus bad transparency, how transparency has evolved in healthcare, how it can empower the consumer to have more control over the prices they pay through evolved technology, and which transparency rules decrease prescription drug prices, and which rules actually increase prices.

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Today, spending on biologic drugs makes up 43% of total drug spending. This is a growing area of new innovation for a multitude of therapeutic areas, and also an area of growing cost. To increase the use of biosimilars, strategies must be implemented to focus on biologics and drive cost-savings. To share these strategies, host JC Scott is joined by two members of Prime Therapeutics, Dr. Joseph Leach, Senior Vice President and Chief Medical Officer, along with Jarrod Henshaw, Senior Vice President and Innovation & Supply Chain Officer. Prime Therapeutics recently announced a major program addressing the increased use of biosimilars. Jarrod explains the differences between traditional drugs vs. biologics and generics drugs vs. biosimilars. Jarrod and Dr. Leach discuss what it means for biosimilars to be interchangeable, how they confront fears and misperceptions on biosimilars, what roles PBMs must play to drive the cost-savings from adoption of biosimilars, and how policies and incentives can encourage the use of biosimilars.

To stop significant increases in drug pricing, greater competition is needed in the drug manufacturing industry. To analyze the role public policy plays in this challenge, host JC Scott talks with Lauren Aronson, health policy expert and Executive Director of the Campaign for Sustainable Rx Drug Pricing (CSRxP). Lauren shares the defining moment that started CSRxP, the main challenges policy experts face in rising drug prices, examples of manufacturers’ unsustainable pricing methods including their patent shenanigans, and potential solutions in creating sustainable methods for affordable drug pricing. They also talk about the current landscape in Congress and the Administration when it comes to political strategies to lower drug costs.

We explore how The Robinson-Patman Act, an antitrust law intended to shield businesses acting as buyers from unfair competition, has impacted the pharmaceutical market from a historical standpoint, how it might be applied in the future, and what it means for public policy on drug pricing and rebates. To explain this, JC Scott sits down with Ross Margulies, a Partner with special expertise in Medicare and Medicaid law at Foley Hoag LLP. JC and Ross discuss the antitrust litigations that have shaped the drug supply chain.

Although the COVID-19 vaccine rollout has had a successful start, major health inequities still exist in vaccine access for underserved communities and underrepresented minorities. 2 million Americans are being vaccinated a day, but less than 20% are underrepresented minorities. In this episode, guest host Claire Winiarek sits down with Dr. Elena Rios, President and CEO of the National Hispanic Medical Association (NHMA), and Dr. Sree Chaguturu, Senior Vice President and Chief Medical Officer of CVS Caremark. Claire, Dr. Rios, and Dr. Chaguturu discuss the unique social determinants for why these inequities exist, why it’s important to reframe COVID-19 vaccination campaigns for specific demographic groups, and how PBMs are working to educate underserved populations on the safety and efficacy of the COVID-19 vaccine.

Although the COVID-19 vaccine rollout has had a successful start, major health inequities still exist in vaccine access for underserved communities and underrepresented minorities. 2 million Americans are being vaccinated a day, but less than 20% are underrepresented minorities. In this episode, guest host Claire Winiarek sits down with Dr. Elena Rios, President and CEO of the National Hispanic Medical Association (NHMA), and Dr. Sree Chaguturu, Senior Vice President and Chief Medical Officer of CVS Caremark. Claire, Dr. Rios, and Dr. Chaguturu discuss the unique social determinants of why these inequities exist, why it’s important to reframe COVID-19 vaccination campaigns for specific demographic groups, and how PBMs are working to educate underserved populations on the safety and efficacy of the COVID-19 vaccine.

The Trump administration enacted the Rebate Rule just before leaving office in November 2020. Analyses on the rule, including from government actuaries, show that the rebate rule would increase Medicare Part D premiums by 25% and increase taxpayer costs by 170 billion dollars. PCMA filed a lawsuit to stop the rebate rule from taking effect. In this episode, host JC Scott speaks with April Alexander, PCMA General Counsel, Vice President of State Regulatory Affairs; and Mark Newsom, principal and founder at Health Evaluation, LLC. JC, April, and Mark discuss the PCMA lawsuit, the impact of the last-minute rebate rule, and the Biden Administration’s approach to addressing the rule.

Many Americans have expressed strong reservations about vaccines in general and a COVID-19 vaccine in particular, and remain unsure about whether to be vaccinated against the coronavirus (SARS-CoV-2). In this episode, guest host ClaireWulf Winiarek speaks with Janet McUlsky, convener of the COVID-19 Vaccine Education and Equity Project, and Susan Winckler, a former Chief of Staff to the FDA Commissioner and current CEO of the Reagan-Udall Foundation for the FDA, about these concerns and the potential messages and messengers that may help improve understanding.

Host JC Scott speaks with Megan Hauck, a former Health Policy Advisor to President George W. Bush, Senator Mitch McConnell, and Chris Jennings, former Senior Advisor for Health Policy for both the Clinton and Obama Administrations. In this episode, Scott, Hauck, and Jennings discuss the election results, what a new president and Congress will mean for healthcare policies, and speculate how shifts in the House and Senate will impact the future of healthcare.

Host JC Scott speaks with Amy Bricker, Senior Vice President of Health Services Supply Chain at Express Scripts and previous commissioner for MedPac. November is National Diabetes Month, and the discussion this week revolves around how PBMs help keep the costs of insulin down and improve patient care.

Host JC Scott speaks with two guests from Humana Pharmacy Solutions. The first, Mona Siddiqui, is senior vice president of clinical strategy and quality at Humana. Her background is in public service, especially with HHS and the Center for Medicaid and Medicare Innovation. The second is Dr. Scott Greenwell, senior vice president of pharmacy solutions at Humana, who played an integral role in launching Humana’s Medicare Part D program. The discussion is around innovation in service delivery both before, during, and after the pandemic.

Host JC Scott speaks with Claire Winiarek, the VP for Policy of PCMA, about the increased use of mail delivery for prescriptions. Winiarek discusses the value of mail service for prescriptions both relative to the pandemic and beyond it.

Host JC Scott speaks with Mark Newsom, the principal and founder at Health Evaluations LLC, on one of the executive orders Trump signed on drug pricing that affects prescription drug rebates for public programs. Newsom discusses how prescription drug premiums will certainly increase with the implementation of this rule.

Dan Judy, Analyst and Polling Expert at North Star Opinion Research, speaks with host JC Scott about his recent polls finding that benefits managers are overwhelmingly satisfied with results on Pharmacy Benefit Managers (PBMs). Despite these positive results, JC and Dan discuss why PBMs still suffer from a “trust deficit” in the public eye.


JC Scott speaks with Doug Long, Vice President of Industry Relations at IQVIA, about the impact of COVID-19 on the pharmaceutical market. IQVIA is a world leader in using data, technology, advanced analytics and expertise to help customers drive healthcare – and human health – forward.

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Host JC Scott speaks with Mostafa Kamal, CEO of Magellan Rx Management, about the evolving role of the PBM market in delivering solutions to its clients. JC and Mostafa also discuss challenges to Medicaid during the current economic downfall, as well as upcoming technological innovations to improve the patient experience.

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Tim Wentworth, the president of Cigna Express Scripts and Cigna Services, talks with host JC Scott about how Cigna–along with the entire pharmaceutical industry–are addressing the COVID-19 pandemic.

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Host JC Scott speaks with Mark Newsom, the principal and founder at Health Evaluations LLC, on the core role of Pharmacy Benefit Managers (PBMs). Newsom goes through the process PBMs take to get us, the consumers, the most effective medications for the lowest premiums. He also discusses PBMs and their role in conjunction with the other players in the industry.