Ep. 177: The Real Reason Your Pharmacy Costs Are So High | A HIT-chat with Louis Gallucci

Prescription drug costs are climbing—but the medication itself may not be the biggest problem. It may be how and where you're buying it. On this episode of The H.I.T. Podcast, Toby Kennedy welcomes longtime friend Louis Gallucci, CEO of Limitless Consulting Group, for a deep dive into one of the biggest challenges facing employer-sponsored healthcare today: pharmacy costs. With 20 years of experience across group benefits, carriers, voluntary benefits, benefits technology, and consulting, Louis explains why employers need to rethink the way they purchase prescription drugs—and start looking at healthcare through the lens of procurement. Pharmacy now represents a significant portion of overall healthcare spending, and Louis shares how a surprisingly small number of medications can account for an enormous percentage of a health plan's total costs. In this episode: Why prescription drug spending has grown so dramatically How just a handful of medications can drive a huge portion of plan spending Why the sourcing channel can matter as much as the medication itself Understanding the enormous pricing differences that can exist for the same drug Why rebates and traditional PBM strategies may no longer be enough How alternatives such as direct sourcing are changing the pharmacy landscape Why HR leaders should start thinking more like procurement directors What self-funded employers need to understand about their fiduciary responsibilities Why employers need to take ownership of their claims data The questions employers should be asking their PBMs and benefits partners One of Louis' biggest messages is simple: employers are the buyers. Your PBM may administer the claims, but employers need to understand what they're purchasing, where the money is going, and whether there is a more efficient way to source the same care. And there's a personal connection to this episode, too—Toby and Louis go back nearly 20 years, from working together early in their careers to attending each other's weddings. Now they're sitting down to unpack how dramatically the benefits and pharmacy landscape has changed.