I have been hearing complaints about Allowable Drug Prices (ADPs) in the pharmacy community for years. Most recently, I have listened as pharmacists have described significant prices drops on medications during the current Covid-19 pandemic. The trouble with these prices, and by extension, any complaints about them, is that most ADPs are MAC (Maximum Allowable … Continue reading Drug Price Changes
Yesterday, the New York Times published an article entitled “How Chaos at Chain Pharmacies is Putting Patients at Risk.” The article recounts how current economic and corporate structures are negatively impacting how pharmacies practice, which in turn can lead to serious, and sometimes deadly consequences. These pressures come, in large part, from the Pharmacy Benefit … Continue reading Pharmacy in Crisis?
We have discussed the tactics of Pharmacy Benefit Managers on this blog many, many times. A recurrent theme is the middleman nature of this industry, making money by paying pharmacies less than they charge the payer–the “spread.” Making money this way is not evil, of course. Every business makes money in this manner. The issue … Continue reading The Devil is in the Details
There have been several reports in the news over the last 12 months about pharmacy benefit managers taking advantage of state-run Medicaid programs by charging exorbitant spreads on prescription drugs. Arkansas, Ohio, Kentucky, and West Virginia are a few of the states currently looking into what amounts to price gouging on the part of the … Continue reading Ignorance, Intertia, and the Pharmacy Benefit
I have seen a lot in my years as a pharmacy owner. And while I often discuss the sometimes questionable tactics of prescription drug plans, sometimes I encounter something so disheartening that it gives me pause. So starts this episode of Tales from the Counter. Several times now, I have had patients question an increase … Continue reading Flummoxed
Prescription audits are an unsavory part of every pharmacy’s day-to-day business. Jump to Scriptrxed’s recent article about PBM audits for a great primer on the topic. I wish I could say that this type of activity was not rampant, but I constantly find myself embroiled in the audit process. Everything Scriptrxed writes … Continue reading Audits
Choice is a wonderful thing. Up to a point. Sometimes, it is possible to have too many options. And sometimes what looks like a veritable smorgasbord of choices turns out to be fantasy. This reality is beginning to appear in the clinical pharmacy software arena. Let me explain. Just a few years ago, our pharmacy ran … Continue reading Data
Over the last several weeks there have been a few interesting references to pharmacies having very high cash prices for medications. The soak-the-poor mentality (as Drug Channels calls it) is an unfair characterization. High Usual and Customary prices (also called U&C or the cash price) in pharmacies are directly related to the Pharmacy Benefit Manager industry applying their terms … Continue reading Insurance and Cash Prices in Pharmacy
Regular readers will recognize that this blog has discussed the tactics of the Pharmacy Benefit Managers at length. A PBM is essentially a middleman that extracts profits by controlling both sides of a transaction. The PBM industry spends most of its efforts marketing to payers. They market their services as helping to simplify the management … Continue reading Don’t Blink or you Might Miss Real Savings
On April 10, PCMA posted INDEPENDENT DRUGSTORE LOBBY AGENDA RAISES GOVERNMENT COSTS, INCREASES DEFICIT on their website. This post appears to correspond with significant backlash being seen by the Pharmacy Benefit Manager industry in several states around the country. PCMA is an industry group for the PBM industry, and the post is a great example of … Continue reading PCMA
