> Use of health data is permitted so long as it’s for payment, treatment or operations

please, do tell me, where "estimating better pricing models to extract more profit" fit into those?

> Doctor writes script -> EHR -> Pharmacy -> Switch -> Clearinghouse —> PA Processing -> PBM/Plan makes determination

All the OP mentions happens way after the fact of those paths you described. People have already been charged. Treatment was already decided.