EP231: Pharmaceutical Contracting, PBMs, Pharmacies, Employers, and the HHS Rebate Proposal: What You Need to Know Now, With AJ Loiacono, CEO of Capital Rx
Episode Description
Pharma Contracting, PBMs, and the HHS Rebate Proposal: What You Need to Know, With AJ Loiacono (EP231)
$186 Billion in Potential Charge-Backs: Who Wins the HHS Rebate Rule Land Grab? Episode 231.
Will the Department of Health and Human Services' rebate proposal materially change pharma's ability to "pay to play" on PBM formularies? With roughly $186 billion in potential charge-backs on the table and implementation details still being worked out, hidden middlemen across the drug supply chain are jockeying for position. In this episode, Stacey Richter talks with AJ Loiacono, CEO of Capital Rx, about the hidden complexity of pharma drug transaction contracting and what the HHS proposal could mean for it.
WHAT YOU'LL LEARN
✅ What the HHS rebate proposal actually does, and why its implementation flowchart is where the real fight is happening
✅ Why any middleman inserted into that flowchart takes a cut — creating a land-grab opportunity among previously hidden players
✅ How pharma, PBMs, pharmacies, and employers are each positioned to win or lose depending on how implementation shakes out
✅ AJ Loiacono's perspective from over 20 years in pharmacy benefits, finance, and software development, including cofounding Truveris
WHY THIS MATTERS
Rebate reform sounds like a technical footnote, but with $186 billion in potential charge-backs at stake, it's a fight over who gets to sit in the dark middle of the drug supply chain and take a cut. Understanding the mechanics AJ Loiacono lays out is essential for any employer, pharmacy, or plan sponsor trying to anticipate how their drug costs might shift.
=== LINKS ===
🔗 Show Notes with all mentioned links: Episode Page
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