actana

Drug costs $10.
Insurance paid pharmacy $12 in 2005 = good enough.
Today, Insurance pays PBM $12
then #PBMs pays Pharmacy $9
#PBM profits $3, Pharmacy loses $1

[actana @actana1]

Pharmacy buys drug for $10

2005, Insurance pays Pharmacy $12
Pharmacy profits $2

2019, Insurance pays #PBM middleman $12
PBM pays Pharmacy $9

Result:
PBM profits $3 plus $ on MFG rebates
Pharmacy loses $1
Insurance saves $0

PBMs growing, Pharmacies closing
#PBMs are insidious

[sparflorida @sparflorida]

"61 percent of community pharmacies are being forced to reconsider participating in the Medicaid system. Another 41 percent are considering whether to close their business."

Check out our newest article on community pharmacies in 83 degrees media #PBMs
https://t.co/PiQgOUyitw

[Madelaine Feldman @MattieRheumMD]

This doesn't count all the money PBMs make in DIR fees, PBM mail order and the lucrative spread pricing. OptumRx, ESI and CVS caremark are money making machines!

[Madelaine Feldman @MattieRheumMD]

THANks TX for passing transparency legislation revealing price concessions from pharma to PBMs. In 2019 there were $850M pr. concess. toPBMs, beneficiaries got< 2% & PBMs kept 20%. The rest went to ins. cos who now own or are owned by the big 3PBMs. "Nice work if you can get it."

[Deb Keaveny @keavenyrx]

Aetna sent us a crappy contract with horrible rates. We countered with reasonable rates and the message back was “Thanks for your response. Unfortunately the terms of this agreement are non-negotiable” And if I decline, they are dropping me from all networks currently in.

[Owen Sullivan @OwenSully22]

Are you going to just whine and complain about how unfair, immoral and unjust PBM practices are, or are you going to stand up for yourself and your profession?? Every single independent pharmacy in the U.S. should be part of this lawsuit!! https://t.co/ZIPlsBgpiz

[Loretta Boesing @BoesingLoretta]

MCOs pay pharmacies at a terrible rate, often below the pharmacy's cost of a 💊 & charge the state a higher amount for that medication than was paid to the pharmacy... called "the spread." Spread is one way these MCOs bilk the state out of millions. https://t.co/axzya7lcDG

[ConcernedCitizen @citizenRPh]

What is a prescription worth? According to PBMs - less than the ingredients

[actana @actana1]

@cparty805 @RoguePharm @LaurenDC5 I would recommend additional deterrents internally.
They WILL get past that 1st layer.

In one case (not my store), they cracked window w/o tripping alarm, blow torched gate lock for 45 min.
Then in&out w/in 1 min.
The key is layers on the INSIDE, no longer the outer barriers.

[actana @actana1]

@RoguePharm Focus on 2nd&3rd "layers."
ALWAYS will get in past 1st b/c have time before alarm trips.

Job is to get in-out w/in 1 min.
Lengthen that to 5+

Create barriers to narrow path to safe & bolt to plywood or floor & bar across safe, 2 internal security gates, dummy safes. It works.

[Jose Lopez @JoseLopezRPh]

There should be no such entity as a manager of pharmacy benefits. With a stroke of a pen the current administration can rid our healthcare of this nightmare. #PBMs do nothing but suck the precious resources out of each and every American. @realDonaldTrump @VP @SeemaCMS

[Lauren Colee Young @LaurenDC5]

And 100% of the 3,057 indepdently owned pharmacies are getting drowning in DIR fees from PBMs! Get them OUT!

[Dave Falk @falk_dave]

Do you see this Legislators? What business is sustainable like this. Get these thieving PBMs out of healthcare. Pharmacies are on the front line of #COVIDー19 we don’t need stimulus with fair reimbursements. Wake up

[actana @actana1]

@JeremyAHancock @RepRickCrawford @SenTomCotton @jasonrapert @realDonaldTrump @SeemaCMS @CMSGov @HHSGov @OIGatHHS @SenateFinance
@AGBecerra @AGRutledge

PBMs really make life hard for pharmacies that are genuinely trying to do good.
Please help independents deal with predatory PBMs.

[actana @actana1]

@jpogue1 More evidence for HCQ.

Not perfect, but enough to push forward with HCQ?

Other countries have been using for some time now w/ some success.

https://t.co/rLw0K3X10G

&

https://t.co/P2bV9IUijs

[actana @actana1]

@AGAshleyMoody Oops. Error in that tweet, should be MC < $3.99
(meaning marginal cost to make that product was less than $3.99)

[actana @actana1]

@AGAshleyMoody 1st, that's not even remotely close to price gouging.
2nd, what is your definition of NOT price gouging?
$3.98?
$2.27?
$1.61?

Marginal Value v. Marginal Cost determines price
His MV > $3.99, so he pays & says thank you b/c he wins
MC > $3.99, so store wins
=>Both win, basic Econ

[Rep Michael Schraa @repschraa]

@falk_dave I will be introducing a similar bill in Wisconsin. OptumRX must see the writing on the wall. The hammer has begun to fall on the greedy #PBM’s

[Vikram B Rao @Vikram_RPh]

@AGAshleyMoody #COVID19 #pricegouging #FixRx #RegulatePBM #SCOTUS @AGAshleyMoody @realDonaldTrump @SecAzar @GovRonDeSantis @TruthRX

[actana @actana1]

Additionally:

If in the market, a mass MFG of a product normally produces a product to retail for $5 b/c their costs are $1.

Another supplier enters the market to supply a good but as they are new entrants, costs are $4 & they market the product at $6.99, is that price gouging?

[actana @actana1]

Such B.S.

Simple Solution:

Nassau County, define the price that the product can be sold at.

Then the pharmacy can determine whether or NOT to make & supply to the public.

If there is no one left to supply more hand sanitizer, oh well.

Problem solved. Just ridiculous.

[Steve Moore @SteveMooreRx]

And NY continues to throw up obstacles to pharmacy services. A pharmacy was fined $5000.00 for selling hand sanitizer for $6.99. $6.99 for something that costs more than $4 to make, before labor costs, hardly constitutes price gouging. We need to do better