Definition: A soulless bureaucrat working for a Pharmaceutical Benefits Manager (PBM) who actively schemes to deny life-saving medications by inventing labyrinthine paperwork, “prior authorization” hellscapes, and fake “cost-saving” algorithms that somehow make insulin pricier. They profit by inserting themselves between your doctor and your medicine, then bleeding both sides dry with arbitrary fees while blaming “market dynamics.” Their performance reviews hinge on how many grandmothers they can force to choose between rent and rheumatoid arthritis meds.
Example: When Karen’s doctor prescribed a critical cancer drug, her PBM’s Pill Bandit demanded 17 pages of forms and a “failed cheaper alternative” that caused organ damage. After 6 weeks of delays, they finally approved it—then tripled her copay. Karen’s insurer congratulated the PBM rep for “maximizing shareholder value.”