Employers Are the True Payors of American Healthcare with Rachel Strauss, Founder and CEO of PBM Princess
Episode Description
Employers can reduce pharmacy spending when they stop treating rising drug costs as inevitable and start using data to challenge how their benefits are structured.
In this episode, Rachel Strauss, Founder and CEO of PBM Princess, discusses her unexpected path into pharmacy benefits and the experiences that led her to launch her own consulting firm. She explains why employers, not insurance companies or pharmacy benefit managers, are the true payers of American healthcare and how claims data can help them make more informed decisions. Rachel also explores PBM rebates, spread pricing, biosimilars, direct contracts, and lower-cost options such as Mark Cuban Cost Plus Drug Company. She explains why transparency alone will not create meaningful reform unless employers understand their data, question industry incentives, and take greater control of their pharmacy spending.
Tune in and learn how employers can challenge the status quo, uncover hidden costs, and make smarter pharmacy benefit decisions.
About Rachel Strauss:
Rachel Strauss is the Founder and CEO of PBM Princess, LLC, a healthcare consulting firm focused on making healthcare more affordable, accessible, and understandable for employers and patients.
With more than two decades of experience in health insurance and pharmacy benefit management, Rachel helps employers, payers, consultants, and healthcare innovators navigate the complex pharmacy benefits landscape. She spent over 20 years at EHIM, Inc., now ProCare Rx, where she helped grow the company from a regional PBM into one of the top 20 PBMs in the United States. She later led strategic development and partnerships across the self-funded employer ecosystem.
Through PBM Princess, Rachel advises organizations on pharmacy strategy, go-to-market positioning, cost reduction, and meaningful industry partnerships. Known for making complicated topics easier to understand, she regularly speaks about prescription drug pricing, PBM structures, healthcare transparency, and patient-first pharmacy benefits.
Rachel has participated in nearly 100 speaking engagements and has been featured in national media, podcasts, and television segments. She also hosts Insfluencers, a podcast highlighting under-recognized healthcare changemakers, and is a contributing producer of the documentary Side Effects May Occur, which explores the PBM and pharmaceutical ecosystem.
Key Takeaways
Employers are the true payers of American healthcare because they ultimately fund premiums and claims, giving them more influence than they may realize.
Claims data can help employers identify unnecessary costs, evaluate alternatives, and make better pharmacy benefit decisions.
Biosimilars and lower-cost purchasing options, such as the Mark Cuban Cost Plus Drug Company, can sometimes significantly reduce spending.
Rebate structures and spread pricing can reward higher drug prices while making it difficult for employers to understand the true net cost.
PBM reform requires clear definitions, better education, and stronger employer involvement, not broad promises of transparency alone.
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