Greg Baker leads AffirmedRx, a pharmacy benefit manager and public benefit corporation that’s shaking up the traditional pharmaceutical supply chain
Greg Baker is angry. He thinks you should be angry, too.
He’s on a crusade to reform traditional pharmacy benefit managers (PBMs), the companies that manage prescription drug benefits on behalf of health insurers. In May 2023, Baker testified before the U.S. House Committee on Oversight and Accountability that a handful of large PBMs control up to 80% of the market, to the detriment of the American public.
“The system isn’t broken,” Baker (BS ’99) says. “It’s working exactly as intended — for-profit companies are making as much money as possible for their investors. That’s what the current system is designed to do. The problem is, we have the wrong system. If we really want to fix health care in America, we’ve got to change the system.”
The so-called big three PBMs — CVS Caremark, Cigna’s Express Scripts and United Health’s Optum Rx — drive up medication costs to increase profits for their shareholders while taking a bigger chunk of revenue from the pharmacies filling those scripts. A June 2023 report published by the Centers for Disease Control stated that 9 million adults in the U.S. can’t afford the medications they’re prescribed.
“Community pharmacies are suffering, self-funded employer insurance plans are suffering and the American public is suffering all while these guys in the middle make literally tens of billions of dollars a year in profit,” says Baker. “It’s just criminal.”
Considering how vehemently he rails against PBMs, it’s a bit surprising that he’s actually the CEO of a PBM, albeit one that takes a patient-first rather than profit-first approach to health care. Founded in 2021, AffirmedRx is a public benefit corporation (PBC) on a mission to improve health care outcomes by bringing integrity, clarity and trust to pharmacy benefit management.
“My opinion is, if you want to fix the problem, you have to be the problem,” Baker says.
According to Mark Cuban, the American businessman, part-owner of the Dallas Mavericks and investor of “Shark Tank” fame, part of the problem is that most CEOs don’t understand health care coverage, and it’s costing them tons of money. In a March 2024 story published in Fortune magazine, Cuban praised AffirmedRx, which now manages pharmacy benefits for his employees, as “an easy switch” for companies “focused on the economics and wellness of their employees.”
That partnership came about after Baker and Cuban chatted over breakfast nearly two years ago. Like Baker, Cuban scorned the middlemen companies for prioritizing profits over patients. He was intrigued by AffirmedRx, a PBM that was also a PBC. In 2022, Cuban launched his own PBC, Mark Cuban Cost Plus Drug Company, a mail order discount pharmacy that provides safe, affordable medication with transparent low prices.
“I think Mark saw a level of integrity, effort and transparency in AffirmedRx that he hadn’t seen elsewhere in the pharmacy chain,” Baker says. “We share a similar vision and values, to do as much good for as many people as possible.”
Fundamentally changing the way the pharmaceutical industry operates isn’t what Baker set out to do when he enrolled in pharmacy school in the mid-90s. His 20-year-old self never envisioned testifying before Congress or eating eggs with a billionaire. But after 25 years working in corporate pharmacy, he’s eager for the future of AffirmedRx and its role in upending how PBMs operate by building a company that makes decisions from a health care standpoint versus a financial standpoint.
“Twenty year-old Greg had a passion to make people’s lives better,” Baker says. “That’s why I went into pharmacy and why I love it. I’m just accomplishing that goal in a different way now. At AffirmedRx, I spend every single day trying to do the right thing.”
This story appeared in the 2024 issue of The Purdue Pharmacist magazine.
