EP461: Pick Only One, Plan Sponsors: Do You Want to Control GLP-1 Volume or Control GLP-1 Unit Cost? With Chris Crawford
Episode Description
This episode with Chris Crawford, CEO of RxSaveCard, is not about the when, why, or how of GLP-1s for weight loss or best-practice prescribing. It's very specifically about the pickle plan sponsors get themselves into often enough where, if they impose formulary restrictions to limit the volume of meds they're paying for, unit prices go up — a real dynamic for GLP-1s and a critical one, given how the costs associated with GLP-1s for weight loss contribute to significant increases in pharmacy trend. Chris Crawford and Stacey Richter discuss the tradeoff plan sponsors face: lower your volume and raise the unit price, or vice versa. Chris also introduces a potential solution leveraging the growing cash marketplace, where employers can bypass traditional PBM contracts to achieve cost savings. This episode is sponsored by RxSaveCard.
WHAT YOU'LL LEARN
✅ The two pieces going on with GLP-1 PBM prices and rebates for employers — and why they pull against each other in a way most plan sponsors don't see coming
✅ Whether the cash price for these name-brand drugs is currently less than the rebated PBM price — and why that answer surprises most plan sponsors
✅ Why the rebate for GLP-1s disappears the moment employers try to put restrictions on who can access these drugs — the core perverse incentive at the heart of this episode
✅ Where RxSaveCard comes into play as a mechanism for employers to access the cash marketplace directly, bypassing the rebate trap entirely
✅ Why "we exist to save people money" is Chris Crawford's simplest articulation of the model, and what it looks like in practice for employers and employees
WHY THIS MATTERS
There's an unfortunate tradeoff, as it stands right now, for many plan sponsors managing GLP-1 coverage: lower your volume and raise the unit price, or vice versa. That tradeoff isn't inevitable — it's a byproduct of how rebate-driven PBM contracts are structured. Tools like RxSaveCard exist because there's real money to be saved once employers step outside that structure and access the cash marketplace directly, and this is a really impactful, not-frequently-delved-into perverse incentive that anyone on or about the pharmacy supply chain needs to understand.
MENTIONED IN THIS EPISODE
EP456 with Brian Reid: Apple Podcasts | Spotify | Other Apps
EP356 with Ge Bai, PhD, CPA: Apple Podcasts | Spotify | Other Apps
EP439 with Luke Slindee, PharmD: Apple Podcasts | Spotify | Other Apps
=== LINKS ===
🔗 Show Notes with all mentioned links: Episode Page
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00:00 Introduction.
07:57 What are the two pieces going on with GLP-1 PBM prices and rebates for employers?
10:00 Is the cash price for these name brand drugs currently less than the rebated PBM price?
11:49 Why does the rebate for GLP-1s disappear if employers try to put restrictions on who can receive access to these drugs?
15:07 Where does RxSaveCard come in to play here?
19:55 "We exist to save people money."
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