PBMs, Insulin, And The Broken System Keeping Prices High with George Huntley

Show Notes
If you have ever stared at your pharmacy receipt and thought, How is this even legal? this episode is for you. George Huntley has lived with type 1 diabetes since 1983, spent 25+ years running employer health plans, and now sits at the center of national advocacy work on insulin access and drug pricing.

In this conversation, George breaks down how pharmacy benefit managers PBMs quietly took over drug pricing, why insulin became the poster child for a broken system, and how rebates turned into a giant, legal kickback loop that almost nobody at the patient level understands. We talk about why insurance started feeling so much worse in the 2010s, how PBMs profit when list prices go up, and why the health plan can actually pay less for insulin while you pay more at the counter.

George also walks through what actually happens behind the scenes when your employer picks a health plan, why most employers have no idea how much money is flowing to PBMs, and why the drugs on your formulary are often chosen for maximum rebate, not lowest cost or best fit. We finish with a rapid-fire True or False round that exposes some of the most harmful myths about PBMs, insulin list prices, and whether transparency alone could fix this mess.

What You Can Do Today

Learn the vocabulary PBM, rebate, formulary so you can ask sharper questions of your HR team, benefits broker, or insurer.
If you work for an employer that offers health insurance, ask whether they know their PBM spread and rebate structure, and if they’ve ever audited it.
Share this episode with one person who helps make benefits decisions at work, or with someone in your T1D circle who has been crushed by insulin costs and needs language for what they’re experiencing.

Resources
Helpful resources and newsletter:
https://yourbestt1dyear.com

Sponsor Connect
Blue Circle Health offers free coaching and care that fits real life for adults with type 1 diabetes. They help with insulin adjustments, CGMs, burnout, and the mental load of diabetes, without fighting the healthcare system alone.
Sign up free at:
https://bluecirclehealth.org

Connect
TikTok: https://tiktok.com/@the.betes
Instagram: https://instagram.com/thebetes
Facebook: https://facebook.com/neilgreathouse
LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912
Website: https://yourbestt1dyear.com

Books on Amazon
Type 1 Diabetes – One Day at a Time
https://a.co/d/6UHooWJ
Type 1 Diabetes – True Stories
https://a.co/d/dfIlyI1

Det här avsnittet är hämtat från ett öppet RSS-flöde och publiceras inte av Podme. Det kan innehålla reklam.

Avsnitt(251)

Walking With Insulin Still Working

The fear episode, faced head-on. The couch was never the real reason people with type 1 diabetes move less. The real reason is the low. So this is the safety net, built from the top shelf: the interna...

30 Sep 8min

Muscle Is Medicine // Strength Training with Type 1 Diabetes (Alex St. John, MSc)

Alex St. John is six foot five, about 295 pounds, and three years into serious lifting when type 1 diabetes showed up mid-semester of his kinesiology degree, at a blood sugar of 504. His response was ...

28 Sep 53min

"Snack" Before You Eat

The graduate seminar of movement snacks, with the loudest safety caveat of the month. A 2014 study in Diabetologia coined the term exercise snacks: short, brisk bursts of movement a few minutes BEFORE...

25 Sep 6min

The After-Dinner Ten

Meet Neil's walking partner: Cora, a 5.9-pound senior Morkie whose hips don't lie and whose top speed is best described as eventually. Every evening, Neil, his wife Gina, and Cora take the after-dinne...

23 Sep 5min

You Don't Need The Gym

Somebody sold all of us the same lie: that getting active means a membership, an hour a day, and a personality transplant. This episode formally cancels that belief system with receipts. Look at the e...

21 Sep 5min

The Movement "Snack"

For once, a study on our actual people. Published in 2026 in Diabetes Technology and Therapeutics: adults with type 1 diabetes on insulin pumps sat for six hours straight on one lab day, and on anothe...

18 Sep 5min

Three Short Walks Beat One Long Walk

Stop looking for 45 free minutes. They don't exist, and it turns out they were never the assignment. A 2013 Diabetes Care study by Loretta DiPietro compared one 45-minute walk against three 15-minute ...

16 Sep 5min

Exercising with Type 1 Diabetes // 34 Years of T1D and Still Moving (Arnie Bunch, the Blood Sugar Ninja)

Arnie Bunch has been living with type 1 diabetes since 1992, the same year Neil was diagnosed. He's a runner, the creator of the #bloodsugarninja, and the kind of friend who gives you the straight ans...

14 Sep 1h 4min