In an overhaul of the nation’s medical pricing structure, President Donald Trump unveiled “The Great Healthcare Plan” on Thursday, explicitly targeting the “kickbacks” paid by pharmacy benefit managers (PBMs).
The ‘Kickback’ Crackdown
The proposal, which aims to slash drug prices and insurance premiums, has found validation from industry experts who characterize these middleman fees as a predatory “vig” that artificially inflates costs for patients.
The core of the President’s plan is a mandate to “End kickbacks from pharmacy benefit managers to the large brokerage middlemen.”
The White House asserts these payments “deceptively raise the cost of health insurance,” a claim supported by the President’s pledge to stop sending subsidies to big insurance companies and instead route funds directly to eligible Americans.
“The big insurance companies lose and the people of our country win,” Trump declared in his announcement speech, promising to lock in “massive discounts” on prescription drugs.
Experts Validate The ‘Vig’
Independent analysis corroborates the administration’s diagnosis of the PBM problem. In a discussion from Jan. 12, on The Real Eisman Playbook, healthcare expert Warris Bokhari, founder of Claimable, described the PBM model as a “pay for play” system.
He explained that PBMs effectively set drug menus based on rebates—a fee structure he likened to a “vig”—rather than patient efficacy.
“If you’re a manufacturer and you want to access like a third of the insured population… the rebate needs to be this size,” Bokhari explained, noting that manufacturers would price drugs “5x lower” if PBMs were removed from the equation.
Transparency And ‘Plain English’
Beyond pricing, the plan demands a “Plain-English Insurance” standard, requiring insurers to publish rate and coverage comparisons without “industry jargon.” This aligns with expert warnings that opaque terms like “valid claims” are often left undefined to facilitate denials.
With the White House calling for “unprecedented accountability”, the new framework sets the stage for a major confrontation between the administration and the healthcare lobby.
Here’s a list of top PBM operators and some pharma ETFs that investors may consider, based on the ongoing calls for reform in the healthcare system.
| Stocks | YTD Performance | One Year Performance | Six-Month Performance |
| CVS Health Corp. (NYSE:CVS) | 1.54% | 56.58% | 27.52% |
| Cigna Group. (NYSE:CI) | -0.42% | -1.08% | -9.12% |
| UnitedHealth Group Inc. (NYSE:UNH) | 0.76% | -33.61% | 15.89% |
| Pharma ETFs | YTD Performance | One Year Performance | Six-Month Performance |
| VanEck Pharmaceutical ETF (NASDAQ:PPH) | 1.27% | 21.46% | 19.51% |
| iShares US Pharmaceuticals ETF (NYSE:IHE) | 1.36% | 28.20% | 26.85% |
| Invesco Pharmaceuticals ETF (NYSE:PJP) | 0.36% | 26.32% | 25.90% |
| SPDR S&P Pharmaceuticals ETF (NYSE:XPH) | 1.49% | 27.40% | 32.55% |
| KraneShares MSCI All China Health Care Index ETF (NYSE:KURE) | 9.55% | 40.90% | 4.96% |
| First Trust Nasdaq Pharmaceuticals ETF (NASDAQ:FTXH) | 1.12% | 23.49% | 27.00% |
| Direxion Daily Pharmaceutical & Medical (NYSE:PILL) | 2.98% | 60.82% | 108.08% |
Disclaimer: This content was partially produced with the help of AI tools and was reviewed and published by Benzinga editors.
Photo courtesy: Shutterstock
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