How a Fiduciary PBM Like DisclosedRx Solves the Vertical Integration Problem

At DisclosedRx, we believe employers and employees deserve better than a system rigged to benefit middlemen. For too long, Pharmacy Benefit Managers (PBMs) have operated behind the curtain of complexity, consolidating power across the drug supply chain and leaving patients to pick up the pieces. The rise of vertical integration—where one company controls the insurance plan, the PBM, and the pharmacy—has turned this imbalance into an institutionalized disadvantage for plan sponsors and members alike.

We exist to fix that.

What’s the Problem with Vertical Integration?

Today, three massive corporations—CVS Health, OptumRx, and Express Scripts—control pharmacy benefits for over 75% of Americans. They don’t just manage drug formularies. They own the health insurance plans and the pharmacies where prescriptions are filled. On paper, it sounds like efficiency. In practice, it means fewer choices for patients, higher costs for employers, and a playing field tilted in favor of corporate profits.

Here’s how vertical integration hurts:

Patients are often forced into mail-order services or branded pharmacies, reducing access and flexibility.

Independent pharmacies get squeezed out by below-cost reimbursements.

Drug prices are manipulated through tactics like spread pricing and rebate-driven formularies.

The “rebate game” benefits the PBM, not the plan sponsor or member.

Cost savings are promised but rarely backed up.

Most importantly, these PBMs are not required, nor contractually obligated, to act in the best interest of the employers or members they serve.

That’s where DisclosedRx stands apart.

The Fiduciary Difference

We are The Fiduciary and Fully Disclosed PBM™ and we mean that in every sense. While others promise savings with fine print that protects them, we contractually commit to working for our clients and their members, no one else. It's in writing. It's in our model. It's in our mission.

Here’s how we directly address the pitfalls of vertical integration:

1. Clients and Members Come First—By Design

Our fiduciary role isn’t a marketing phrase, it’s an ethical and operational standard. We are contractually bound to act in your best interest. That means:

No favoring one pharmacy over another for our own gain.

No steering members to services that benefit us.

No padding our pockets with rebate margins or spread pricing games.

The vertically integrated PBM model prioritizes profits. We prioritize outcomes for your people and your bottom line.

2. No Games. Just Full Disclosure of All Financials

You will always know what you’re paying and what you’re getting. We pass through 100% of all rebates. We charge you exactly what we pay pharmacies. No hidden fees. No buried costs. No surprises. If a PBM can’t show you every dollar flowing through the system, ask yourself: Who is that money really working for?

3. One Revenue Stream, One Mission

Unlike vertically integrated PBMs with multiple revenue incentives and internal business units to feed, DisclosedRx operates with a single source of revenue: our service fee. That means our success depends entirely on the value we deliver to you, not on backdoor deals, retained rebates, or owning the pharmacy you’re required to use.

4. Savings Promises, Backed by Guarantees

The traditional PBM model makes vague savings promises with no accountability. We don’t do that. We offer a contractual guarantee on savings. If we don’t deliver what we say we will, we pay the difference. Period. That’s not just a promise, it’s protection.

Solving the Vertical Integration Crisis, One Client at a Time

At DisclosedRx, we aren’t trying to become the next pharmacy chain or insurance company. We’re not building a healthcare empire. We’re building trust by putting your interests in writing, backing our performance with guarantees, and refusing to profit at your expense.

When the system is stacked against you, a fiduciary partner levels the playing field.

If you’re ready to move past broken promises, complex rebate games, and the constraints of vertical integration, we’re here to help.