Big Pharma

[KP, Pharm.D. @kpharmd12]

Attention @medmutual of Ohio:

Just processed a prescription for 30 tablets of generic Crestor for a patient who uses your God-awful insurance plan through the ACA.

Guess what your chosen PBM provider @ExpressScripts pays me to dispense this medication to your member?

If you guessed 47 cents with a $0 patient co-pay, you’d be correct.

Something strongly tells me that @medmutual is being billed by @ExpressScripts for a much higher amount.

I wonder if @ExpressScripts mail order would ship out a prescription for less than 50 cents?

Costs more for a damn stamp.

[Natalie F Danelishen @Chesschick01]

Bernie Sanders and AOC haven't created a single millionaire.

Elon just created 4,400 millionaires.

Socialism vs. Capitalism

[Kim "Katie" USA @KimKatieUSA]

This is the moment a customer busted two @Shell workers running the screw scam to charge gas to other customers.

He told them straight: take the screws out or I’m ruining your entire company.

I’m so sick of people coming to America just to scam hard-working citizens. Deport every single one running these street-level cons.

[NJ Assembly GOP @NJAssemblyGOP]

Highest property taxes in America. 2nd worst overall tax climate in the nation. Highest corporate tax rate in the nation. Record $60.7B state budget being negotiated right now.
And Democrats wonder why companies keep leaving. #NJTaxes #NJPolitics

[Wall Street Apes @WallStreetApes]

California Democrats are preparing to ban essentially ALL after market tires

This is a real proposal from the California Energy Commission called the Replacement Tire Efficiency Program

“I mean pretty much every aftermarket tire sold in the state is going to be regulated, and no one is talking about it — Tires use energy, some more than others, and California wants to lower the energy use of tires on their vehicles so less CO2 goes into the atmosphere”

It’s for climate change….

I looked into what their plan is

It would require all replacement and aftermarket tires sold in California to meet strict low rolling resistance standards similar to those on new cars (OEM tires)

Tires that don’t meet the targets phased in starting 2028, with stricter rules in 2031 could not be legally sold in the state

OEM tires on new cars are optimized for low rolling resistance (better fuel economy/lower emissions), but this often means shallower tread depth, shorter lifespan, and sometimes reduced grip

Many popular aftermarket tires (especially performance, all-season, or longer-lasting ones) have higher rolling resistance for better handling, durability, or traction. So they will be banned

Here’s what it really means for every day people

Lower rolling resistance leads to more frequent tire replacements, increasing production emissions and costs

It does the exact opposite of what Democrats are saying. It’s a proposal that’s being prepared to be passed

[KP, Pharm.D. @kpharmd12]

Medicare GLP-1 Bridge Program

“Pharmacies will be reimbursed at the wholesale acquisition cost of a drug, less the beneficiary copay of $50, plus a dispensing fee of $3 for each Medicare GLP-1 Bridge claim”

A whole $3 dispensing fee?

Golly gee, let me invest that into the S&P 500 and get my retirement fund set up!

[Elon Musk @elonmusk]

💯

[Nick Sortor @nicksortor]

WOW! The governor of New Jersey just revealed 5 of the 6 people arrested here outside the Newark ICE facility by NJ State Police were from OUT OF STATE

Once again: NOTHING about this is organic.

NJ GOV. SHERRILL: “We know that people from outside the state have been interfering in the protests and escalating them. 5 of the 6 people arrested last night by state police were from outside New Jersey”

[Forest Park Pharmacy @ForestParkPharm]

If you've ever needed a prescription, you already know this scene by heart. 🎭

Doctor sends it in. Insurance says: "prior authorization required." Pharmacy faxes the form. Insurance loses the fax. Doctor refaxes. Denied. Appeal it. "Overturned"… then re-pended. Three phone calls, two weeks, and a hold-music playlist later, you still don't have the medication you needed on day one.

This isn't a glitch. It's the design. Every delay, every "fax it back," every mystery denial is a system built to wear you down until you give up — while a middleman (the PBM) quietly decides what your medication "should" cost and pockets the spread.

Here's the part nobody tells you: for a huge number of common generics, your insurance isn't saving you money. It's the reason you're overpaying.

At Forest Park Pharmacy, we cut the middleman out entirely. No prior-auth maze. No fax purgatory. Just the LOWEST-priced generic medications, cash price, posted plainly so you can see exactly what you'll pay before you ever walk in. 💊

Your prescriptions shouldn't require a part-time job to manage. Check your price. Transfer in minutes. Get back to your life.

[Big Pharma @plocht]

@davepl1968 That’s the way it was in suburban NJ

[KP, Pharm.D. @kpharmd12]

What other business would be actively persuading people to take their business elsewhere?

Imagine a small business selling a $500 product, but telling the customer to go to a larger competing company to purchase that product instead.

By purchasing the $500 product elsewhere, it would prevent the smaller company from losing money selling it to the customer.

Also, the larger competing company makes a significantly higher profit than the smaller company.

Sounds extremely dumb, right?

It happens multiple times a day owning/operating a small pharmacy.

I refuse to believe that employees at Best Buy would be telling customers to go to Walmart to buy their next TV, but maybe I’m wrong.

[Forest Park Pharmacy @ForestParkPharm]

Sen. Warren laid it out plainly: Express Scripts reportedly billed the DoD ~$484 MORE per generic drug when it filled the script at its own pharmacy.

The DoD official's response? "I'm not aware of the cost."

Asked why 13,000 pharmacies have walked away from TRICARE? "The contractor is meeting its contractual requirements."

Let that sink in. Here's one drug — Droxidopa, 90-day supply:

💵 Cash, no insurance: $180🏪 TRICARE pays an independent: $131🏬 TRICARE pays a big chain: $2,400🏴‍☠️ Express Scripts pays ITSELF: $9,700

Same pills. Same bottle. The only thing that changes is who's pocketing the spread — and it's the middleman, every time.

And they don't stop at gouging pharmacies. They gouge patients too. That same drug at an Express Scripts pharmacy? $13 copay. At your local independent? $48 — even though the independent option saves the plan over $9,000.

You read that right. They charge YOU more to steer you toward the option that costs the PLAN more. Because the friction is the point. Every closed pharmacy, every inflated price, every "I'm not aware" — it all feeds the same machine.

This is why we fired Express Scripts and the PBM middlemen who profit by making your healthcare worse.

No PBMs. No hidden fees. Just transparent cash pricing.

[Forest Park Pharmacy @ForestParkPharm]

UnitedHealth just had the chance to save Texas Medicaid a ton of money.

Guess what they did instead.

Last month, a generic version of Farxiga hit the market. Here's the price difference:

→ Brand Farxiga: ~$600/month
→ The new generic: ~$20 for a 3-month supply

That's roughly $7,000 per patient, per year. Multiply that by the number of Texas Medicaid patients on this drug and you're looking at millions of dollars in savings on a single medication.

Texas Medicaid is still paying for the brand.

Why?

Because UnitedHealth doesn't want the cheap option. They get a massive fee from the manufacturer for every brand-name prescription. They get a kickback per fill. The expensive drug staying on the formulary is how they make money. The cheap generic showing up wipes that revenue out.

So here's where it gets fun.

Texas Medicaid uses a Drug Utilization Review Board to vet the formulary. They meet quarterly. They just met. This massive savings opportunity? Never came up.

That's not an accident. The list of drugs the board reviews is provided by OptumRx — the PBM owned by UnitedHealth Group.

The company that profits from the overpayment gets to decide what the board is allowed to look at.

Farxiga must have slipped their mind.

Meanwhile, Texas is stuck overpaying so the company they hired to control costs can pocket millions. That's the whole game.

We fired the PBMs. No contracts, no rebates, no kickbacks. Just real cash prices.

[Sama Hoole @SamaHoole]

A zookeeper walks into the lion enclosure with a salad. The lion eats him.

A zookeeper walks into the giraffe enclosure with a steak. The giraffe is confused but politely declines.

A zookeeper walks into the panda enclosure with bamboo. The panda eats roughly twelve kilos of it and digests about two.

A zookeeper walks into the gorilla enclosure with twenty kilos of leaves and shoots. The gorilla spends nine hours eating it and produces an enormous, satisfied pile of waste.

A zookeeper walks into the wolf enclosure with raw meat. The wolf eats it. Nobody questions this.

A zookeeper walks into the chimp enclosure with fruit, with the understanding that the chimp will also occasionally hunt and eat smaller monkeys, and that this is normal.

Every species, in every zoo, in every country, is fed what its anatomy says it should eat.

Then we get to the human.

The human, who has a stomach acid pH of 1.5, a short carnivore gut, forward-facing predator eyes, a brain built on animal fat, and two million years of skeletal evidence of hunting and butchery behind him.

This animal, the registered nutritionist explains, should have a plate that is half vegetables, a quarter whole grains, and a small triangle of protein.

Why? Because.

The same logic that feeds a lion meat and a giraffe leaves stops dead at the door of the human enclosure.

A different rule applies to us, apparently. A rule written by people who have never observed our anatomy and have never seen what we actually evolved to eat.

The other animals get the truth about what their bodies need. The human gets the food pyramid, a glossy leaflet, and a polite suggestion to maybe cut back on red meat.

Strange, isn't it.

[Kendra @whoop97]

Congratulations Tennessee 👏 👏

[Jack Mozloom @JMozloom]

CVS sues Tennessee to halt law that could close pharmacies. Wow, the ink on the law isn’t dry yet and CVS is suing to block it. No surprise. https://t.co/ns8jmdBK79

[Pharmageddon 💊⚛️💪 @sterlingkoonce]

This must happen nationally to save community pharmacy access. Especially in rural areas.

[Dutch Rojas @DutchRojas]

Laying off 1,000 nurses to fund a $25 million football practice facility is exactly why we need to stop pretending health systems are charities.

[Elisabeth Potter MD @EPotterMD]

I woke up to a message from New Hampshire. A bill had made it to the state Senate — one that Representative Julie Miles championed after watching me do peer-to-peer calls with insurance reviewers who weren't qualified to be making decisions about my patients. I'm a surgeon in Texas. I had no idea this had traveled that far.

Between cases at Redbud today, I fired off emails to NH Senate members, logged into a YouTube Live, and watched HB 1554 pass.

Here's what it does:
✅ Requires peer reviewers to be actual peers — credentialed, named, with their NPI number and specialty certification on the line
✅ Allows physicians to communicate with that peer reviewer at any point in the prior auth process — not just after a denial or on appeal

This is a patient-centered, common-sense reform. And it happened because someone posted something. Told the truth. Did the right thing.

Thank you, Representative Julie Miles and Senator Tim McGough. New Hampshire just set a standard. I hope other states are paying attention.

Get involved. Speak up. You never know what good it might do.

[KP, Pharm.D. @kpharmd12]

Just did a price check online through https://t.co/n01LhR1H0j for #60 pregabalin (Lyrica) 75mg capsules utilizing the Part-D Plan @WellcarePlans

Walmart price = $34.47

CVS price = $33.60

Walgreens price = $33.60

Kroger price = $33.60

Genoa Healthcare (subsidiary of United Healthcare) = $12.45

Any independent pharmacy = $4.80

Does anyone see the problem here?

Is @WellcarePlans comfortable paying large chain pharmacies 7x more than an independent pharmacy for the same prescription medication?

Apparently they are.

So much for @ExpressScripts “negotiating” lower prices for Americans.

How many unsuspecting people get screwed when their local “cheap” pharmacy option closes because $4.80 doesn’t cover their operating expenses, let alone the cost of the drug?

Then their only options are Walgreens, Walmart, CVS where they get to pay over $30 for the same drug.

Small pharmacies aren’t negotiating to be the cheapest option. If we accept the insurance contract, they TELL US what we get to charge the patient.

Make it make sense! @DrOzCMS @DonaldJTrumpJr @realDonaldTrump @DrMakaryFDA @CMSGov