Pivot Podcast: A Conversation with Capital Rx CEO A.J. Loiacono

Episode Highlights

• AJ comments on Walgreens' expansion into specialty pharmacy, calling it a "very logical move" given growth rates for specialty and cell and gene therapy (CGT). However, it is not clear how they will wedge their way into fulfillment and compete with the "Big 3;" he says, "There's no natural access point."
• When asked about unbundling PBM services, AJ explains that it's already commonplace, as Capital Rx has proven, but vertical integration - the end of the mega-mergers - was destined to make people angry on the health plan side of the market.
• Healthcare has been slow to evolve, but competitive forces have put the market on a trajectory toward more unbundling.
• The FTC's ongoing inquiry into the true economic structure and competitive forces in the PBM industry is one thing, but you can't rely on the federal government to upend or transform the industry. The revolution that a lot of people are seeking or discussing will be driven by competitive forces remove opacity and improve patient outcomes. "There's no one author to change."
• AJ opines that "swinging for the fences" and breaking up the largest vertically integrated company would result in breaking up several other players, which would likely be very, very difficult to implement, in his opinion.
• The healthcare infrastructure in the U.S. is like the electrical grid - it's aging, vulnerable, and static. It's also one of the biggest cost drivers. There's about 25% of "pure waste" in the system due to administrative burden. AJ explains why Capital Rx built JUDI® and the flexibility and workflow improvements this modern enterprise health platform offers. It's time for a sea change - we must upgrade this country's infrastructure to provide the healthcare we deserve.

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For more information on this episode, please visit: MedCity Pivot

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Get in touch with us if you'd like more information about Capital Rx's transparent PBM business model or PBA solution.

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