Prescription drug prices in the U.S. haven’t just crept up, they’ve spiraled into a full-blown crisis. The reason isn’t just Big Pharma or bloated insurance plans.

The real culprits are PBMs (Pharmacy Benefit Managers), corporate middlemen so deeply embedded in the system that they now control which drugs are covered, how much patients pay, and whether your local pharmacy can even stay in business.

Doug Hoey, CEO of the National Community Pharmacists Association, has spent years fighting these opaque and unregulated players. Doug has seen firsthand how PBMs operate. Quietly extract billions from the system, manipulating formularies, steering patients into mail-order services they own, and using aggressive tactics like clawbacks to recoup payments months after a prescription is filled.

PBMs claim to reduce costs, but the opposite is happening. Patients are paying more, pharmacists are being pushed out of business, and entire communities are being left without access to care.

What are some of the sneaky tactics PBMs use? How can we fix the healthcare system so local pharmacies don’t go out of business and patients can access the care they need?

In this episode, Doug breaks down how PBMs became some of the most powerful and least accountable entities in healthcare, how their influence distorts medical decision-making, and what real reform could look like.

Things You’ll Learn In This Episode

-The Real Reason Drug Prices Feel So Broken 70% of your prescription cost isn’t for the drug itself. How are PBMs driving up the cost of medication?

-How PBMs Hijack Decisions From Your Doctor What happens when a corporation’s rebate deal with a drug company matters more than your diagnosis?

-The Hidden Agenda Behind Mail-Order Prescriptions Why are PBMs pushing you out of your local pharmacy and into their own delivery networks?

-The Pharmacy-Killing Practice No One Warned You About What does it mean when PBMs “claw back” money months after a prescription was filled, and how does that put small-town pharmacies out of business?

-The Consumer Power That PBMs Don’t Want You to Use What simple questions can you ask your HR department or local lawmaker that could help overhaul the entire system?

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Guest Bio

Douglas Hoey is the CEO of the National Community Pharmacists Association. The National Community Pharmacists Association represents the owners of nearly 19,400 small pharmacy businesses. These pharmacies are important to local economies, providing jobs for 215,000 people in their communities, and consumers consistently rank them as the top-rated pharmacies in the country. Hoey is a licensed pharmacist in Oklahoma, Virginia, and Texas, and practiced in a variety of community pharmacy settings, including his own family’s pharmacy before coming to NCPA. Hoey was NCPA’s first chief operating officer and in 2011 was named CEO. He is widely quoted by media as an industry expert on community pharmacy practice issues including drug supply and prescription drug pricing. Hoey also developed and taught pharmacology courses at George Washington University and Marymount University. He is president of the World Pharmacy Council, co-chairman of the Surescripts Board of Directors, chairman of the NCPA Innovation Center, and vice-chair for the CPESN® USA Board of Managers. Hoey served on the Pharmacy Quality Alliance board for six years and was chairman of the Mirixa board for eight years. His pharmacy degree is from the University of Oklahoma College of Pharmacy, and his MBA is from the Oklahoma City University Graduate School of Business. Visit https://ncpa.org/ to learn more.

About Your Host

Steve Hoffart is an award-winning pharmacist, entrepreneur, speaker and podcaster. As the visionary founder of Magnolia Pharmacy, Steve saw a need for a more personal pharmacy that could make a bigger impact. Today Steve and his team of experts deliver on that promise, working with patients and their physicians to solve medication problems and offer personalized solutions to achieve better health and wellness. As host of The Trusted Pharmacist podcast and through his combined reach of over 250,000 on social media, Steve shares actionable advice on nutrition, supplements, and wellness strategies while advocating for meaningful change in healthcare.

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