Today in Des Moines, the House Government Oversight Committee held a hearing looking into PBMs and the high prescription drugs. Several pharmacies and a national PBM were requested to appear. Our own Randy McDonough was one of those asked to speak. You can view the committee meeting on Facebook (search for JohnForbes4Iowa). The direct link to … Continue reading Iowa Follows Arkansas Lead with Legislative Hearing
We serve a patient with severe mental disabilities living in a group home. He has full time staff assisting him with his medications. Our pharmacy provides the patient’s medications packaged to meet the rules and regulations for this type of residential care facility. These packaged medications are delivered in monthly installments. The prescription drug plan … Continue reading Am I a Part of the Problem or a Part of the Solution?
Shortly after finding yesterday’s story about Express Scripts mail faux-pas, I was alerted to another news piece from prospect.org written by David Dayen covering some of CVS-Caremark’s anti-competitive behavior. This article is worth reading as it does a good job of explaining many of the more complex and dishonest tactics a PBM uses, and it also points … Continue reading ReBlog: Abusing Drugs
What happens when an industry can direct entire populations? They will eventually flex their muscle and their monopoly position. An excellent example of the unchecked-power the PBM industry has over the pharmacy industry occurred in Wisconsin recently, with a PBM sending out letters to members misleading them into switching pharmacies. One of the choices, of … Continue reading Re-Blog: Local pharmacies losing business from accidental third-party mailer
Recently we rolled the dice and moved our giant capsule token in the game of Pharmopoly. We landed on Community Chest and drew the infamous: The actual prize was several thousand dollars paid back to our pharmacy from a True-Up done to correct DIR fees withheld from our remittance back in 2015. While this is … Continue reading Monopoly and the DIR fee
Over time the Thriving Pharmacist has reported many different problems with Pharmacy Benefit Managers and the stranglehold they often have over the profession and practice of pharmacy. In many ways, pharmacy is to blame for allowing this power over itself become entrenched. At least part of this is pharmacy owners and chain executives not paying … Continue reading The Noose
Pharmacies dispense medications, and by default are a part of the drug distribution channel. Drug Channels, a blog by Adam Fein, which covers topics across the entire pharmaceutical industry, regularly writes analyses that include pharmacy. The public has a similar perception centered on drug (medication) distribution. The dictionary is also among those that primarily identify pharmacies and pharmacists as distributors … Continue reading Pharmacy is More Than a Drug Distribution Channel
Over the last two or three months, we have been observing an accelerating pace of critical news stores focusing the business practices of both the PBM industry and Drug Manufacturers. Now, Rueters is reporting that twenty states are suing Mylan and Teva over drug pricing. Knowing what I do about lawsuits, it will be quite some time before … Continue reading Dominoes
News articles looking closely at the PBM industry appear to becoming popular. Ken McEldowney, with Morning Consulting takes yet another look at the practices of this middle-man industry. He makes several good observations including: The oligopoly that is the PBM industry not only hurts struggling consumers, it also makes jaw-dropping profits off of them. In … Continue reading Re-Blog: Health Care Has a Middleman Problem
Pharmacy is an interesting business. Unlike most other business models, pharmacy does not completely control the price it charges for services and product. Pharmacy Benefit Managers have leveraged several aspects of contracts and healthcare to remove significant parts of the free market. These include indirect manipulation of a pharmacy’s Usual and Customary Prices, maintaining independent MAC lists, and … Continue reading The Art of the Claw-Back
