Disruption Interruption on Disrupting a $500B Monopoly: Mark Mincy Reclaims Millions for Employers
Mark Mincy, CCO at US RX Care, exposes the conflicts of interest and hidden fees within the pharmacy benefits industry. He discusses how employers are misled by consultants and PBMs and offers a path to reclaim savings through transparency and fiduciary responsibility.
TAMPA BAY, Fla., Nov. 20, 2025 /PRNewswire/ -- The U.S. pharmacy benefits industry, a $500 billion sector, is dominated by just four Pharmacy Benefit Managers (PBMs) controlling 67% of the market. (1,2) This concentration leads to inflated drug costs and a system riddled with conflicts of interest. Mark Mincy, Chief Commercial Officer at US RX Care, joins host Karla Jo Helms (KJ) on the Disruption Interruption podcast to discuss how his company is challenging this broken model by demanding transparency and helping employers reclaim millions in savings. "We're driven by the gross exploitation of patients and organizations," Mincy states. "Companies and employers are trying to do the right thing, but they are being misled by both their consultants, in most cases, as well as their PBM partner."
The Tangled Web of Rebates and Hidden Fees
The pharmacy benefits system is designed to benefit middlemen, not employers or patients. PBMs and their consulting partners often make choices that are in their own financial interest, driving up costs for everyone else. This is achieved through a complex system of rebates and purchasing contributions that can account for up to 80% of a drug's total cost.
"To get your drug on the formulary, you have to agree to pay this 30 to 40% purchasing contribution along with the 30 to 40% rebate," Mincy explains. "Now you can see if 80% of the cost of the drug is going to the PBM, the pharmaceutical manufacturers have to increase their cost at least fivefold to make those payments." This inflation creates a snowball effect where PBMs have extra funds to pay consultants to steer more business their way, further consolidating their market power.
A Path to Transparency and Savings
US RX Care offers a disruptive solution by operating as a true fiduciary, demanding transparency and eliminating conflicts of interest. The company passes back 100% of rebates and offers per-member-per-month guarantees, which takes the guesswork out of budgeting and aligns incentives with the employer's best interest. This model stands in stark contrast to the opaque pricing and retrospective payments common in the industry.
"If you have a PBM that has a per member per month guarantee, now you have a budget. You actually have a budget for this thing and now they're under the pressure of performing to that budget," says Mincy. He advises employers to join healthcare purchaser coalitions, hire experienced ERISA attorneys to review contracts, and find non-conflicted consultants. By doing so, companies can protect themselves from litigation and regulatory risks while driving meaningful change in the industry.
Links
Disrupting the Consultant-PBM Loop: Bringing True Fiduciary Duty to Pharmacy Benefits, with Mark Mincy
LinkedIn: http://www.linkedin.com/in/mark-mincy-a185497
Company Website: https://us-rxcare.com
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About Disruption Interruption™
Disruption is happening on an unprecedented scale, impacting all manner of industries— MedTech, Finance, IT, eCommerce, shipping, logistics, and more—and COVID has moved their timelines up a full decade or more. But WHO are these disruptors and when did they say, "THAT'S IT! I'VE HAD IT!"? Time to Disrupt and Interrupt with host Karla Jo "KJ" Helms, veteran communications disruptor. KJ interviews badasses who are disrupting their industries and altering economic networks that have become antiquated with an establishment resistant to progress. She delves into uncovering secrets from industry rebels and quiet revolutionaries that uncover common traits—and not-so-common—that are changing our economic markets… and lives. Visit the world's key pioneers that persist to success, despite arrows in their backs at www.disruption-interruption.com.
About Mark Mincy
Mark Mincy is a trailblazer in the realm of pharmacy benefits risk management, demanding radical transparency and fiduciary responsibility in an industry long resistant to both. As the Chief Commercial Officer at US-Rx Care, Mark is leading the charge to disrupt the pharmacy benefits ecosystem with a technology-driven solution that empowers self-insured employers and health plans to reclaim millions in savings—without requiring them to change their existing PBMs.
With a career spanning decades in pharmacy benefits and managed care, Mark has built a reputation for delivering sustainable cost reductions and improving plan beneficiary savings. At US-Rx Care, he oversees all aspects of pharmacy risk management, including specialty pharmaceutical savings, ensuring clients receive uncompromising, independent oversight that works entirely in their best interest.
Prior to joining US-Rx Care, Mark held leadership roles across the industry, including Regional Vice President at EnvisionRx, where he managed PBM sales for the Eastern Region, and Vice President of Managed Care at Walgreens, where he directed managed care strategies and contract negotiations. He also served as Co-Owner at Prime Rx Med and Interim President at Ikon Group, further solidifying his expertise in pharmacy management and risk mitigation.
About Karla Jo Helms
Karla Jo Helms is the Chief Evangelist and Anti-PR® Strategist for JOTO PR Disruptors™. Karla Jo learned firsthand how unforgiving business can be when millions of dollars are on the line — and how the control of public opinion often determines whether one company is happily chosen, or another is brutally rejected. Being an alumnus of crisis management, Karla Jo has worked with litigation attorneys, private investigators, and the media to help restore companies of goodwill into the good graces of public opinion — Karla Jo operates on the ethic of getting it right the first time, not relying on second chances and doing what it takes to excel. Helms speaks globally on public relations, how the PR industry itself has lost its way, and how, in the right hands, corporations can harness the power of Anti-PR to drive markets and impact market perception.
References
- Mukkamala, Bobby. "Unchecked Power in PBM Industry Puts Patients at Risk of Harm." American Medical Association, 5 Aug. 2025, ama-assn.org/about/leadership/unchecked-power-pbm-industry-puts-patients-risk-harm.
- Pharmaceutical Research and Manufacturers of America. "Patient Access and Affordability." Phrma.org, 2025, phrma.org/policy-issues/patient-access-affordability.
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727-777-4629
SOURCE Disruption Interruption
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