From Commentary to Solutions: Why Fixing PBMs Requires Action, Not Noise

By Scott Martin, CEO of Rescription

If you spend more than five minutes in a conversation about pharmacy benefits, you’ll hear the same refrain: the system is broken.

PBMs are broken. Drug pricing is broken. Transparency is broken.

Everyone agrees. Everyone nods. And then… nothing changes.

The industry has become an echo chamber: long on commentary, short on solutions. While pointing out problems can feel productive, it rarely delivers progress.

For employers, brokers, and TPAs responsible for managing pharmacy benefits, identifying what’s broken is only useful if it leads to fixing it, which requires action. At Rescription, we believe progress comes from execution, not commentary.

The Echo Chamber of “The System Is Broken”

Criticism of PBMs isn’t new. Conferences, whitepapers, LinkedIn posts, and panel discussions are filled with sharp critiques of rebate games, misaligned incentives, and pricing opacity. Much of that criticism is valid.

However, too often, it stops there.

Calling something broken doesn’t make it better. Repeating the same diagnosis without offering a treatment only reinforces the status quo. The industry debates what’s wrong instead of demanding what works.

We’ve written before about Why PBM Reform is Essential. The takeaway was simple: if the traditional PBM model is fundamentally misaligned, then incremental tweaks won’t fix it. You have to build something different.

Common Questions Employers and Brokers Ask About PBMs

How is Rescription different from a traditional PBM?

Traditional PBMs profit when drug costs rise through rebates and volume-based incentives. Rescription operates on a subscription-based model, passing drugs through at their sourced price so savings flow directly to employers and members.

Who is this PBM model designed for?

Rescription is built for self-funded employers, public sector plans, brokers, and TPAs who want radical clarity, predictable costs, and aligned incentives.

Does this approach actually reduce costs?

Yes. By eliminating rebate economics and prioritizing sourcing strategies, employers typically see 70%+ savings on pharmacy spend and clearer reporting.

An Entrepreneurial Career Built on Action, Not Theory

Rescription didn’t come from a think tank or a theoretical framework. It came from experience.

I have spent my career building companies by solving real operational problems, not just talking about them. Across industries, the pattern has been consistent: identify where incentives are misaligned, simplify what’s been overcomplicated, and execute.

That same approach applies to pharmacy benefits.

“Everyone’s talking about what’s broken with PBMs. It’s like government with endless arguments and no solutions. We have one, and it’s simple.”

Instead of publishing another critique of rebate-driven pricing, Rescription eliminated rebates altogether. Instead of accepting that PBMs make more when drugs cost more, Rescription adopted a subscription-based model, one where the only way to win is to save clients’ money.

That’s not theory. That’s a business decision.

The Difference Between Noise and Progress

Noise is easy. Progress is harder.

Noise looks like:

• Panels that rehash the same complaints

• Reports that confirm what everyone already knows

• RFPs that measure complexity instead of outcomes

Progress looks like:

• Passing drugs through at their sourced price

• Aligning incentives so savings benefit employers and members

• Making pricing simple enough to understand without an actuary

At Rescription, progress means delivering measurable results, such as lower net costs, clearer pricing, and better access to medications, without relying on smoke, mirrors, or fine print. We work with employers and brokers nationwide, supporting plans across multiple states with a consistent, transparent PBM model.

It also means saying less and doing more.

Offering Answers, Not Just Commentary

The healthcare industry doesn’t need more commentary about what’s broken. It needs models that prove a better way is possible.

Rescription exists to be that proof.

By rejecting rebate economics, removing volume-based incentives, and focusing entirely on outcomes, we’ve built a PBM model designed to work the way employers and members expect it to.

Simple. Transparent. Aligned.

That’s how systems actually get fixed—not by shouting louder about the problem, but by quietly delivering the solution.

Want to see what action looks like in practice?

Learn more about Rescription’s approach to pharmacy benefits and why doing the opposite of what’s broken is sometimes the most practical path forward.