SILRPH- SK

PharmD, independent pharmacy owner, patient advocate and PBM fighter

[SILRPH- SK @snkloos]

This is awesome! America 🇺🇸

[KP, Pharm.D. @kpharmd12]

CVS unveils “pharmacy-only” store in Chicago.

“Each location will average less than 5,000 square feet, and will feature a full-service pharmacy with limited over-the-counter products available for purchase”

You just described what an independent pharmacy does.

This is not earth-breaking news.

Maybe if reimbursements from CVS Caremark weren’t dog-shit garbage, then more pharmacies like this wouldn’t have been forced to close in their communities.

Just some food for thought @CVSHealth @cvspharmacy, not like you all give a shit about what’s best for any given community.

[SILRPH- SK @snkloos]

@CSexton25 @rxman95 Rate is fixed and non-negotiable. Typical PBM language.

[Ted Okon @TedOkonCOA]

CVS spending millions and will do anything to stop legislation prohibiting corporations from owning both a #PBM and pharmacies. Their business model is built on owning both plus owning an insurer. #PBMob #PBMs

https://t.co/hQHqDUTpNC

[Pharmer Trent @tmac622]

Joyner said there were too many pharmacies. Sounds like a solution @CVSHealth

[Welcome to Costco, I love you! @BrawndoDrinker]

@sterlingkoonce I know a family owned chain of 60+ years that just closed because of PBMs. People don’t understand that it’s not that pharmacies aren’t making enough, it’s that they’re losing big $ on most rx’s. Congress doesn’t care bc PBM lobbyists 💰💰💰

[Mark Cuban @mcuban]

Why do the big drug distributors seem to get a pass when it comes to healthcare cost dysfunction ?

The fact that pharmaceutical wholesalers buy at what is effectively retail price is the foundation of pharmacy pricing dysfunction

The only industry I know that buys at retail price.

As a result
1. Indy pharmacies pay more cash out of pocket then pray they get reimbursed a fair amount.
2. Patients pay this price, full retail, during their deductible phase and a percentage of this inflated number for coinsurance
3. PBMs make a killing because they charge employers, manufacturers and patients fees and apply rebates as a percentage of WAC.
4. You don’t want to look at how this works for specialty drugs. It’s so profitable that these wholesalers are buying clinics to keep the business under their control.
5. This is the flu in the ointment in DTC. Pharm to table ? More like dollars to expensive middlemen charging a fortune that keeps the DTC prices higher than they need be. Fortunately some some manufacturers are realizing that consignment is a better supply chain model than what is currently happening

6. If brand manufacturers went completely to consignment for all brand and specialty drugs, the above might have to come to reality.

Or

If they went to all net pricing then:
Pharmacies would have more cash and less reimbursement risk.
Patients would pay far less during the deductible phase, and less in coinsurance and more
Spread pricing would be less of a problem
Etc.

Can someone explain to me why the big wholesalers get a pass when evaluating why healthcare costs are so horrific ?

[Pharmageddon 💊⚛️💪 @sterlingkoonce]

If a business is unfairly and contractually paid under cost to provide a product, and it fails, does that make them a bad business person?

If a competitor, that is owned by the afore mentioned “middleman” from above, pays their own business significantly better, does that make the competitor a better business person?

NO on both counts. Unfair business practices obscure genuine good and bad businesses. Monopolies win every time.

[Terry Wilcox @Terrilox]

I was Heard on the Hill in @DC_Reporter today … “When one company controls the insurance, the pharmacy benefit, and the pharmacy counter, patients stop being customers and start being captives. This Judiciary Committee report shows how CVS used its power to block competition that would have given patients more choice, more transparency, and lower costs. That’s not a market failure — it’s a patient ripoff.” — I stand by all of it, especially the part about the patient ripoff!

More to heard later this week from @mcuban

https://t.co/NZL6ylqx3h

[Sarah Huckabee Sanders @SarahHuckabee]

Arkansas was the first state in the nation to ban PBM’s anticompetitive actions.

Now, Congress has found that CVS Caremark - one of the largest - may have violated federal law. It’s time to hold these companies accountable.

https://t.co/dU5FQadlhk

[KP, Pharm.D. @kpharmd12]

Time for Congress to amend ERISA?

I can’t open this app anymore without hearing about another lawsuit against PBMs or another pharmacy shutting down.

They are the problem, but no one can cut them off at their knees. Someone needs to accomplish that before all retail pharmacies are extinct.

[Mark Cuban @mcuban]

Make them divest all Non Insurance assets. They are Too Big To Care

[SILRPH- SK @snkloos]

@kpharmd12 I sold my independent pharmacy to the local hospital last month. Couldn’t continue losing money every day. Now I am a pharmacist, taking care of my patients and not concerned about paying the wholesaler, the taxes, the mortgage, the payroll, the health insurance. I’m lucky.

[Mark Cuban @mcuban]

😭😭😭

Who exactly is going to cut their prices ? Independent physicians can barely pay their bills. DPC is already a bargain. Hospitals are going to get rid of facility fees or walk away from keeping 340b margins and passing that to the patient ? No.

Big PBMs are going to stop charging fees ? No. Big insurers are going to stop gaming vertical integration transfers ? No

Break up the big insurance companies first. Make them divest each vertical , PBMs, Providers, ASOs , Digital They are the ATT1984 of 2026.

Break them up.

They have become Too Big To Care

[Dutch Rojas @DutchRojas]

𝐘𝐨𝐮 𝐤𝐧𝐨𝐰 𝐭𝐡𝐞 𝐅𝐢𝐯𝐞 𝐅𝐚𝐦𝐢𝐥𝐢𝐞𝐬.

UnitedHealth.
CVS.
Elevance.
Cigna.
Centene.

𝐓𝐡𝐞 𝐟𝐨𝐫-𝐩𝐫𝐨𝐟𝐢𝐭 𝐯𝐢𝐥𝐥𝐚𝐢𝐧𝐬 𝐞𝐯𝐞𝐫𝐲𝐨𝐧𝐞 𝐡𝐚𝐭𝐞𝐬.

But they didn't build this system.
They inherited it.

Introducing: The Five Dynasties.....🧵

[Rep. Jake Auchincloss 🟧 @RepAuchincloss]

Too much of the economy is captured by monopolists and middlemen. Pharmacy Benefit Managers are both. My bipartisan legislation will stop their unfair tactics, support community pharmacists, and lower Rx drug prices. https://t.co/hiz7B6iQGT

[SILRPH- SK @snkloos]

@PolitiBunny Bulgogi burger over Jasmine rice

[SILRPH- SK @snkloos]

@kmccor2014 We demand a signed HIPAA release be faxed to the pharmacy before any information is released. The fax never comes and the information is never given out.

[American Pharmacies @APRxNews]

Rite-Aid Sues CVS Caremark to Recoup Over $500 million in DIR Fees

A bankruptcy trustee sued CVS Caremark and its affiliates on behalf of Rite-Aid in federal bankruptcy court. The 55-page complaint alleges breach of contract, breach of Medicare statutes and rules and antitrust violations.

🗓️The complaint was filed on August 22, 2025, in the Bankruptcy Court for the District of New Jersey.

[Americans For Pharma Reform @BustBigPharma]

Big Pharma shells out $10+ BILLION every year on ads. Their goal? Not to educate consumers, but to buy off the media. Big Pharma knows the networks won't bite the hand that feeds them.

🚨 Add your name to a list of Americans demanding that Congress take action: