Hannah Mamuszka and Lena Chaihorsky interview Greg Baker, founder and CEO of AffirmedRx, a pharmacy benefit manager structured as a public benefit corporation. Baker, a pharmacist who spent years running on-site pharmacies for large employers, argues the drug-pricing system isn’t broken but “working as designed” to maximize shareholder profit. He explains how the dominant PBMs make money as a percentage of drug cost, creating an incentive to favor expensive, highly rebated brands over cheaper generics, and how manufacturers must compete on rebate size for formulary placement, using Humira and Enbrel as his example. He describes what he calls a rebate “shell game,” in which PBMs route rebates through offshore group purchasing organizations (Express Scripts’ Ascent, in Switzerland) to obscure how much they keep. AffirmedRx, he says, charges a flat per-claim fee, passes rebates through fully, and caps executive pay. He points to recent ERISA lawsuits against employers (J&J, Wells Fargo, JPMorgan) as a turning point. A closing segment covers pharmacogenomics: why a person’s metabolism affects whether a drug works, and how a cheek-swab test could reduce trial-and-error prescribing.
July 8, 2026
Episode 6 — Greg Baker (AffirmedRx): The Rebate Shell Game and a Different Kind of PBM
