The Rebate Trap: Why Your Employees Are Paying Full Price for Half-Price Drugs

In this episode, a pharmacy benefits expert and advisor exposes one of the most quietly damaging mechanics in the employer health plan system… the rebate trap. The math is simple and the implications are devastating: a $1,000 drug carries a $500 rebate, your employee pays $1,000 at the counter, the rebate flows back to the PBM, and your employee never sees a dime of it.

This is not a technicality. This is a structural design that transfers money from your employees' pockets directly into the PBM's bottom line and most employers have no idea it's happening. As described in this episode, it's worse than overpaying on your taxes.

What You'll Learn:
How the rebate system works in practice and who actually benefits from it.
Why an employee can pay $1,000 for a drug that should cost them $500, with no recourse.
Where the $500 rebate goes when a PBM keeps it instead of passing it to the plan or the member.
Why drug rebates function as an interest-free loan to both the drug manufacturer and the PBM.
How the nine-month lag between paying full price and receiving any rebate dollars compounds the financial harm.
What employers need to demand in their PBM contracts to ensure rebates flow back to the plan and the people who need them.

Timestamps
00:00 - Introduction
00:30 - The $1,000 Drug With a $500 Rebate
01:15 - What Happens When the PBM Keeps the Rebate
02:00 - Your Employee Just Paid Double What They Should Have
02:45 - Rebates as an Interest-Free Loan to Drug Companies and PBMs
03:30 - The Nine-Month Lag: Paying More Now, Getting Less Back Later
04:15 - Why This Is Worse Than Overpaying on Your Taxes
05:00 - What Employers Can Do to Reclaim Rebate Dollars

Видео The Rebate Trap: Why Your Employees Are Paying Full Price for Half-Price Drugs канала Ethos Benefits