Why Your Prescriptions Cost So Much: A Pharmacist Explains PBMs

Why does the same medication cost dramatically less in other countries while Americans are stuck choosing between prescriptions and rent?

In this episode of Connected by Health, Dr. Krishna Vedala sits down with Alexander Vedala, a licensed pharmacist and CEO of Sooner Pharmacy and Compassionate Care Pharmacy, to expose what's really driving prescription drug prices in the U.S. and why patients feel trapped inside a system that's supposed to protect them.

As Alexander puts it, PBMs were "supposed to help reduce cost to medications"… but the incentives got "tainted."

You'll hear a behind-the-counter breakdown of the biggest cost drivers, including:

• PBMs (pharmacy benefit managers) as the "middleman" gatekeepers between manufacturers and insurers

• Rebates that don't reach patients: "They don't pass that through to the patient."

• Spread pricing: the insurer sees one price, the pharmacy gets another "and they're pocketing that money."

• Steering patients to mail-order through higher copays at local pharmacies (often owned by the PBM)

• Why independent pharmacies are being squeezed, especially in rural communities where access is already fragile

And yes, they talk real numbers and real human impact.

Alexander shares a personal story that brings the entire issue into sharp focus:

"My youngest son has type one diabetes… and that's just not affordable for a lot of people."

This isn't just a rant about what's broken. It's a roadmap for what could change.

You'll hear actionable reform ideas, including:

• Moving toward transparent "cost-plus" pricing (and what Mark Cuban's Cost Plus Drugs gets right)

• Eliminating or reducing prior authorizations that delay care

• Rebuilding incentives so drug pricing isn't driven by profit from inflated costs

• Expanding pharmacists' role to reduce delays and expand access ("you guys know the dosing if not better than we do")

• Why "provider status for pharmacists" could help patients get faster, cheaper care

Alexander also makes the case for coalition-level advocacy across the healthcare team:

"We'd be much more powerful if we could get together… joining the fight."

If you've ever wondered why your prescriptions are expensive, confusing, or delayed; this episode will give you clarity (and probably a few jaw-dropping moments).

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Where Health, Society, and Innovation Intersect

Connected by Health is a forward-thinking podcast built on a simple but powerful truth: healthcare is not a cost to be cut — it is an investment that shapes the future of everything around us.

Millions of people struggle with healthcare challenges each year — whether it's lack of insurance, unaffordable costs, limited access to care, or managing chronic disease — affecting not only their health, but their financial stability and overall quality of life. Their stories are not isolated — they are all connected. From economic growth and workforce productivity to education, technology, national security, and community stability, health is the thread weaving them together.

Each episode blends real-world stories with data-driven insight to show how strategic healthcare investment drives innovation, reduces long-term costs, strengthens public health infrastructure, and fuels economic resilience.

Grounded in evidence but driven by purpose, Connected by Health reframes healthcare not as a line item expense, but as foundational infrastructure — because when we invest in health, we invest in people, potential, and the strength of our entire society.

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