J Anthony Ware

Cardiologist, drug developer, board member AnaptysBio, recovering professor of medicine, science enthusiast, author, amateur rock critic, father, husband.

[Mark Cuban @mcuban]

Disagree. The problem starts because PBMs use their formulary leverage to threaten brands with lowering their formulary access if they don’t sell to distributors at WAC- (or equivalent)

That leaves the margin room for the PBMs rebates.

But there is no other good reason to sell to distributors at WAC-

Look at Eliquis at $600 WAC. -5 pct = 570.

Which means the distributor has to sell to pharmacies for $570 plus float

Which means pharmacies have to sell to uninsured patients, and patients in their deductible at $570 or more then beg PBMs to be fully reimbursed (unless they own the pharmacy )

If instead they sold to distributors at Net plus. They could sell to them at $300 because they aren’t paying the rebates and fees to the PBMs.

The distributors could sell to pharmacies at $335 and make more money , while the pharmacies could sell to uninsured and deductible phase patients for $345 and not worry about Pbm reimbursement and make money and the patient gets the same price we sell for

Get the PBMs out of the way or remove their formulary control and @costplusdrugs , distribution and others can take the job of negotiating

This is the only industry I have ever seen where the manufacturers are forced to sell at retail price

And how do I know they are forced ? Every brand ceo I have asked has told me the exact same thing

[Mark Cuban @mcuban]

The same companies you say are denying claims, are the ones you prop up buying access to formularies.

Tell your members to stop being afraid of the PBMs and the insurance companies that own them, or they own.

Your members selling to distribution at WAC and making up categories of Class of Trade to protect PBMs , is costing patients billions per year. Making your medicines unaffordable to many.

I get that the PBMs can crush your sales with formulary manipulation, but if you truly care about patients , it’s time for you to stand up to them. Go to the DOJ and the FTC, tell them how it works.

Or maybe you want to be able to use rebates to buy market share and let patients die or get sicker because they can’t afford to pay list price.

The industry is broken. Stand up to it

[J Anthony Ware @JAnthonyWare]

@HeartOTXHeartMD The team managing my investment portfolio

[Mark Cuban @mcuban]

Most insurers aren’t insurers. They are holding companies that arbitrage capitated systems and self insured employers, looking for weaknesses and lack of contract enforcement in state, federal and commercial organizations

[J Anthony Ware @JAnthonyWare]

A wonderful boss and role model, and a huge influence on my career.

[American Heart Association @American_Heart]

The American Heart Association mourns the passing of the legendary cardiologist Eugene Braunwald, M.D., widely recognized as one of the most influential figures in the history of cardiovascular medicine. Over seven decades, his work reshaped the understanding and treatment of heart disease, leading many to call him the father of modern cardiology.

Braunwald was a lifelong contributor to the American Heart Association, helping advance its research and scientific mission, and was honored with some of the Association’s highest honors for his lasting influence on cardiovascular care and research. His influence extended well beyond his own discoveries, as generations of Association‑supported investigators, clinicians and academic leaders were trained by Braunwald or guided by the clinical trial standards and mentorship models he helped establish.

https://t.co/ieZuHYMyOP

[J Anthony Ware @JAnthonyWare]

@20th_Centurygal Mick Taylor

[J Anthony Ware @JAnthonyWare]

@cremieuxrecueil Well, must admit, I haven’t found being a APOE4 homozygote horrifying, or even highly relevant to my life. I’m 73, no cognitive impairment, no physical impairment, and I haven’t done anything special other than manage my lipids. There is a LOT of noise in the data.

[J Anthony Ware @JAnthonyWare]

Mick Taylor reunited with the Stones, back when Charlie was alive. Doesn’t get better, in my book

[Just Rock Content @JustRockContent]

“Can't You Hear Me Knocking” - The Rolling Stones
https://t.co/oLtzqiMRfQ

[J Anthony Ware @JAnthonyWare]

@crockpics Mick Taylor, for sure

[Evan DeSimone @Smorgasboredom]

Hard to believe that every living economist was right and and a demented game show host was wrong.

[J Anthony Ware @JAnthonyWare]

Beautiful cover. Love Adrien Quesada’s guitar lines

[Traces of Texas @TracesofTexas]

Black Pumas version of the classic Wichita Lineman is pretty dang good!

https://t.co/XybS7zOMQR

Another super Texas band!

[Mark Cuban @mcuban]

If you plan on the existing big insurance carriers offering plans to retailers and associations, this plan will be garbage.

The big insurance carriers will not only do what they do today, they will create more information asymmetry for the associations and retailers than what we see today. Which will allow them to do more of all the fucked up things they do today.

The ACA has failed because you and your peers, on both sides , did nothing to stop insurance carriers and hospital networks from becoming the behemoths they are today.

They will continue to underpay or no pay everyone they can. They will continue to use their PBMs to rip off patients. Do you really think they will all of the sudden make their PBms honest when they sell through Costco , Amazon, Home Depot , whoever ? Hell no. They will make it worse.

I’m all for ending state line restrictions. Allowing docs to start own hospitals But you have to recognize the current market is not efficient. Not close at all

Which allows the behemoths, carriers and hospital networks to be economically abusive.

Get the DOJ and FTC to look at breaking up these enormous companies , and then you might have some real , transparent competition that benefits from consumers shopping for themselves

[J Anthony Ware @JAnthonyWare]

I’ll say it again, THIS is who should be running HHS.

[Mark Cuban @mcuban]

Talking to independent physicians, it's obvious that the big insurance carriers are doing to them, what their PBMs are doing to independent pharmacies.

They deny, underpay, slow pay, clawback, and create administrative mazes, knowing their victims don't have the time or resources to fight.

Why ? By putting financial pressures on physicians and pharmacies, it makes them more likely to sell their businesses to them , close their doors, or refer the business to their captive pharmacy or provider. All benefitting the biggest insurance companies

We need to ditch the concept of "claims" and make every delivery of medications or care as a billable event that must, by law, be paid on a timely basis , with interest charges for any delays. If the physician or pharmacy doesn't deliver , the carrier has plenty of legal options already. As does the patient.

This is not an efficient market. This is the big guy abusing the little guy. It needs to change to better the care we get in this country

[J Anthony Ware @JAnthonyWare]

@PTSportsFix Earl Campbell

[Mark Cuban @mcuban]

It's happening

https://t.co/UBie4ChQXH

[Ray Wylie Hubbard @raywylie]

michael murphy, johnny vandiver, guy, townes, billy joe but the ones I looked up to most was 'spider' john koerner, dave 'snaker' ray and 'little sun' Tony glover.

[J Anthony Ware @JAnthonyWare]

@raywylie Congratulations my friend!

[J Anthony Ware @JAnthonyWare]

Best boss I ever had.

[Patrick Collison @patrickc]

David Ricks is very impressive -- I really enjoyed this one.

[J Anthony Ware @JAnthonyWare]

One might think that a physician would have preliminary idea of how insurance works, but not this one. From my home town, no less.

[Dr. Roger Marshall @RogerMarshallMD]

Up to 40% of Obamacare enrollees never file a claim. That’s billions in taxpayer dollars flowing to insurance companies for people who don’t even use the system.

Republicans are committed to ending the fraud and making healthcare truly affordable.

[Chaz Hong MD PhD 🇺🇸 @chaz_hong]

Like him or not, that Cheney lived to 84 years old is a powerful testament to modern cardiovascular medicine. He was vasculopath: First heart attack at age 37, third heart attack by 47, requiring quadruple bypass surgery, 4th heart attack at 50, severe heart failure requiring defibrillator at 60, surgical repair of arterial aneurysms in both legs at 64, LVAD at 69, Heart Transplant at 71. Truly amazing! https://t.co/sc0KBp71Mr