The schoolyard bully doesn’t like it when the other kids finally stand up for themselves.
Such was the case this week when CVS Health posted a 4-paragraph response to losing the $400 million State of Louisiana employee and retiree pharmacy benefits contract.
With zero irony, the largest health company in the U.S. complained on their LinkedIn page:
“By inserting themselves in the state’s process of selecting a firm to manage prescription drug coverage … special interest groups representing Louisiana’s independent pharmacists attempted to line their own pockets at the expense of the state’s taxpayers, employees, and retirees …
“This situation has set a dangerous precedent, endangering the healthcare coverage of state employees, threatening the fiscal solvency of the state employee and retiree benefit plan, and emboldening special interest groups whose sole concern is lining their own pockets. This bullying behavior, at a time when the state is facing unparalleled economic uncertainty from a global pandemic and countless natural disasters, is nothing short of shameful. Moreover, it represents an alarming trend that all states should be concerned about.” …
How important is patient privacy? One would think it pretty important, given the federal government’s passage of the Health Insurance Portability and Accountability Act (HIPAA) some 24 years ago. But once again it seems pharmacy benefit managers (PBMs) see themselves as above the law. And now apparently so does the Eight Circuit Court of Appeals.
The Eighth Circuit recently ruled in favor of the nation’s largest and arguably one its smarmiest pharmacy benefit managers (PBMs), Express Scripts (ESI), after a group of independent pharmacies accused ESI of using confidential customer information to steer patients to its mail-order pharmacy.
The pharmacies argued that Express Scripts was collecting unnecessary information in its own self-interests. …
Petersburg is a small Central Illinois town some 20 miles outside of Springfield. An agricultural community nestled on a bluff overlooking the Sangamon River, it’s the kind of idyllic midwestern town big city folks imagine when talking about old fashioned American values — a safe, simple, quaint existence. A place where restored Victorian homes peacefully coexist amid local shops and residents enjoy a bounty of fresh fish, venison, and backyard-harvested produce. A place where neighbors know each other’s names and look out for one another; a town safe from the ravages of a global pandemic.
Until it isn’t.
Pharmacist Dave Bagot remembers the day he got the text. …
Following Friday’s announcement by President Trump of the signing of four new Executive Orders aimed at reducing the price of prescription drugs for Americans, Pharmacists United for Truth and Transparency (PUTT) is cautiously optimistic that some of these Executive Orders will result in the fulfillment of promises made by the President two years ago.
While we are most hopeful for the Executive Order “prohibit(ing) secret deals between drug manufacturers and pharmacy benefit manager middlemen, ensuring patients directly benefit from available discounts at the pharmacy counter” we respectfully ask the Trump Administration to consider the following questions:
- What protections will be ensured for patients, plan sponsors and providers should rebates and other proprietary “deals” be prohibited by law? A documented, defining characteristic of the PBM business model is to rename or reclassify rebates as “management fees” which are then collected and kept by the PBMs. These types of “trade secret” deals have contributed to record profits for PBM middlemen, including those recently announced for CVS and UnitedHealth, despite the COVID-19 pandemic and economic downturn experienced by the rest of the country. …
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