Six-Week Virtual Course · Winter 2027
A practical, plain-language course on Pharmacy Benefit Managers — how drug pricing really works, where the money goes, and how to hold your PBM accountable.
$350 WHA Members · $500 Non-Members · Certificate of Completion
About the Course
Pharmacy Benefit Managers sit at the center of prescription drug pricing — yet most plan sponsors sign contracts, approve plan designs, and pay the bills without a clear view of how the money actually moves. This six-week course closes that gap.
Over six 90-minute sessions, you’ll build a working knowledge of how the drug supply chain operates, where the risk sits, and how to question your PBM, read your contract, and design a plan that controls cost without harming members. It’s practical, not academic — every session ends with questions you can take straight back to your own plan.
Your Instructor
Dr. Susan Hayes brings more than 40 years in health care consulting and the PBM industry. As founder of Pharmacy Investigators and Consultants, she leads PBM procurement, audit, and consulting work for Fortune 500 companies, health plans, and government clients — specializing in analytics and fraud detection.
She has provided expert-witness testimony in more than 35 cases, including Rutledge v. PCMA before the U.S. Supreme Court, and has testified for the Department of Justice and the Federal Trade Commission. She authored the chapter on healthcare crimes in White Collar Crimes: A Practitioner’s Perspective, and directs the Health Informatics Master’s Program at Roosevelt University.
Week by Week
Each session moves from foundation to application — and closes with a set of “questions to ask” you can bring back to your own PBM and consultant.
The scale of U.S. drug spend, the five trends reshaping the market — specialty dominance, biosimilars, Medicare negotiation, antitrust scrutiny, and GLP-1s — and why 2027 is a pivotal year for plan sponsors.
The vocabulary that matters — AWP, MAC, WAC, NADAC, NDC — the “Big Three” PBMs and vertical integration, and how spread pricing and rebates actually generate PBM revenue.
Where the ambiguous language lives, which definitions and performance guarantees are worth relying on, and how to run a PBM RFP — going it alone versus hiring a consultant.
The levers you actually control — copays, tiers, exclusions, and utilization management — with an extended case study on how GLP-1/weight-loss drugs are reshaping cost-control strategy.
The category now driving over half of drug spend: what counts as “specialty,” the rise of biosimilars, and why prior authorization and site-of-care programs often don’t work as advertised.
The legal framework, the patterns behind real enforcement cases, and the concrete contract language and operational tools a plan can use to detect and recover losses.
Outcomes
A working understanding of how PBMs operate and where drug costs come from
The ability to read a PBM contract critically and spot the terms that favor the PBM
Practical insight into RFPs, plan design, and specialty-drug and fraud oversight
Greater confidence evaluating PBM performance — and better questions to ask
A certificate of completion for your professional record
Who It’s For
A mixed cohort of benefits professionals who buy, advise on, or oversee pharmacy benefits.
HR and benefits leaders responsible for pharmacy spend
Taft-Hartley and public-trust decision-makers
Advisors who want to go deeper on PBM strategy
Staff who manage plan design and vendor relationships
Why It Matters
“You can’t negotiate what you can’t see.”
Transparency starts with literacy. This course gives purchasers the tools and confidence to engage PBMs more effectively — and drive better outcomes for the people they cover.
Six Fridays · Winter 2027
One cohort, capped at 20. Submit the form below to reserve your place.
Not sure whether your organization is a WHA member? Contact Nick Jackal, Director of Member Engagement, at njackal@wahealthalliance.org.