How Health Insurers Are Buying Your Pharmacy Behind the Scenes

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How Health Insurers Are Buying Your Pharmacy Behind the Scenes

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Episode 30 of Services Economy with Fexingo dives into the quietly transformative trend of vertical integration in healthcare: health insurers buying pharmacy benefit managers and specialty pharmacies. Lucas and Luna unpack the 2023-2026 wave of mergers — including Cigna's acquisition of Express Scripts, UnitedHealth's Optum Rx, and CVS Health's Aetna deal — and explain how these integrated models change drug pricing, consumer choice, and the economics of prescription drugs. They focus on one concrete angle: the rebate wall. Why does a health insurer now profit from steering you to expensive brand-name drugs? And what happens when the company managing your insurance, your pharmacy, and your drug benefit is the same parent entity? Specific data points include the percentage of generic prescriptions dispensed at PBM-owned mail-order pharmacies, the average rebate percentage on brand drugs, and the rise of 'spread pricing' in Medicaid managed care. A grounded, numbers-driven conversation about what vertical integration really means for your healthcare dollar. #HealthInsurance #PharmacyBenefitManagers #VerticalIntegration #DrugPricing #RebateWall #OptumRx #ExpressScripts #CVSHealth #Aetna #Cigna #PBMs #SpecialtyPharmacy #SpreadPricing #Medicaid #HealthcareEconomics #Business #FexingoBusiness #BusinessPodcast Keep every episode free: buymeacoffee.com/fexingo

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