I just spoke with another Indy pharmacy owner, he has a patient that works for a company that has a self funded health plan (they pay the claims). One of their employees had to go on humira- the pbm charged the plan $14,000. Every 28 days.
The pharmacist/ owner found a biosimilar alternative that reduces the cost to $3k.
Pbms DO NOT reduce drug costs. Perfect example of intervention by a pharmacist saved the patient and the payer (business)
Enjoyed a great conversation with @RepAuchincloss & @ToddEury re The Pharmacists Fight Back Act & Patients Before Monopolies Act which cut to core of unfair PBM practices & their causes. Indies need relief and patients need access to indies. @_APCI@TruthRX@mass_marion
"Give me an example of why I should care about PBM reform."
Drug for Multiple Sclerosis: Teriflunomide
Cost: $16
What Caremark insurance reimburses their own "specialty" pharmacy: $6,229
A 38,000% markup. That profit markup is paid out of everyone's premiums with Caremark insurance, and it is paid to their own pharmacy, which is owned by shareholders of CVS stock. If you have Caremark insurance and pay your premiums, this is why it's more expensive than what it should be. This is why medications are so expensive in America.
This is why you should care about #pbmreform
Putting this as a reminder of how twisted PBMs are as a primer for anyone who still doesnt see the problem. All credit goes to @mcuban Pinning this given the recent failure of Congress, thanks to Elon/Vivek.
@Commpharmacy@realDonaldTrump@DOGE@elonmusk Wait, what? A measure that saves $5 billion, and saves small businesses, and curbs the pirates who are robbing seniors and taxpayers, is shot down by the Department of Government Efficiency! This ain’t over.
@elonmusk@realDonaldTrump billionaires protecting parasite billionaires is a horrible look, even for you two. You just gave UHG, CVS Health and Cigna the best Xmas gift they’ve ever gotten! And you screwed everyone else in the country at the same time!
@elonmusk To address this real problem, you must cut military spending,Social Security, and Medicare/Medicaid. Otherwise you are disingenuous in wanting to rein in spending.
Two days ago, Trump was a hero to patients and pharmacies, now he has caved to the insurance lobby and demanded Republicans do a CR without PBM reform. So much for knocking out the middle men. Congress: put PBM reform back in the CR!
This temporary funding bill is Donald Trump's Christmas gift to UnitedHealthcare, Cigna, and CVS Caremark. So much for 'knocking out the drug middlemen'. I'm voting No.
#𝐏𝐁𝐌𝐬 𝐓𝐚��𝐠𝐞𝐭𝐞𝐝 𝐢𝐧 𝐇𝐞𝐚𝐥𝐭𝐡 𝐃𝐞𝐚𝐥
Lawmakers agreed to attach a sweeping health care package to a year-end stopgap government funding legislation, according to text obtained by The Hill ahead of the release of the full bill.
📑 https://t.co/84P2I6tL10