It started with one question: what are employers actually paying for prescriptions?
In 2022, Mark Cuban's Cost Plus Drug Company started publishing what generic drugs actually cost to make and dispense. For many common prescriptions, the cash price was a small fraction of what employer health plans were paying through their PBMs. Since the Consolidated Appropriations Act of 2021, those employers are legally responsible for showing their pharmacy costs are reasonable. Yet almost none of them ever see a line-by-line view of what their PBM charged.
We started ZeroPBM in Boston in 2023 to give them that view using public data. Every week, CMS publishes what pharmacies really pay for drugs. We compare every claim a plan paid against that benchmark, show the employer exactly where the money went, and get paid only when we find savings.
A year later, a Johnson & Johnson employee sued the company, alleging its plan had paid more than $10,000 for a generic multiple sclerosis drug that pharmacies sell for under $100. Since then, fiduciary lawsuits over drug costs have become a real risk for every self-insured employer, and the work we started in 2023 has become something they can no longer put off.