Paul H. Flowers Jr.Senior Business Consultant, Superior Insurance Advisors, LLC · 2024 Hot 100 honoree. 2026 Health Value Award. Fiduciary process documented. 30 to 40 percent health-plan savings for 100 to 2,000 employee CFOs. 3x number one bestseller.

Who Really Profits When Your Drug Costs Rise? (The PBM Game)

29 Jun 2026 · 1 min

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Pharmacy benefit managers, owned by the same insurers that set your health premiums, control 80% of U.S. prescriptions and pocket rebates from drug makers. With fully insured plans, employers never see that money. Self-funded plans let you keep unspent funds if you ask what's actually happening to your pharmacy dollars.

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Here is a question almost no business owner asks: Who actually profits when your employees' drug costs go up? Look closely. The company managing your pharmacy benefit is often owned by the same carrier setting your premium. 3 middlemen, PBMs, now control roughly 80% of every prescription filled in America. They negotiate a rebate, keep the spread, and your people still feel it at the counter and in their paycheck. Fully insured, you never see any of it. Self-funded employers pull the contract into the open and keep what they do not spend. Ask one question before renewal: Where does our pharmacy money actually go?