Posts filed under: Business

Recently, a prominent national PBM made significant and severe adjustments to their Maximum Allowable Cost (MAC) rates for generic drugs. As a result, here in Iowa we have seen a staggering increase in our Underwater (paid less than it costs us to purchase) generic prescriptions. The week that this change is obvious in the graphic......
Continue Reading →
We serve a patient with severe mental disabilities living in a group home. He has full time staff assisting him with his medications. Our pharmacy provides the patient’s medications packaged to meet the rules and regulations for this type of residential care facility. These packaged medications are delivered in monthly installments. The prescription drug plan......
Continue Reading →
Shortly after finding yesterday’s story about Express Scripts mail faux-pas, I was alerted to another news piece from prospect.org written by David Dayen covering some of CVS-Caremark’s anti-competitive behavior. This article is worth reading as it does a good job of explaining many of the more complex and dishonest tactics a PBM uses, and it also points......
Continue Reading →
What happens when an industry can direct entire populations? They will eventually flex their muscle and their monopoly position. An excellent example of the unchecked-power the PBM industry has over the pharmacy industry occurred in Wisconsin recently, with a PBM sending out letters to members misleading them into switching pharmacies. One of the choices, of......
Continue Reading →
Recently we rolled the dice and moved our giant capsule token in the game of Pharmopoly. We landed on Community Chest and drew the infamous: The actual prize was several thousand dollars paid back to our pharmacy from a True-Up done to correct DIR fees withheld from our remittance back in 2015. While this is......
Continue Reading →
Over time the Thriving Pharmacist has reported many different problems with Pharmacy Benefit Managers and the stranglehold they often have over the profession and practice of pharmacy. In many ways, pharmacy is to blame for allowing this power over itself become entrenched. At least part of this is pharmacy owners and chain executives not paying......
Continue Reading →
Pharmacies dispense medications, and by default are a part of the drug distribution channel. Drug Channels, a blog by Adam Fein, which covers topics across the entire pharmaceutical industry, regularly writes analyses that include pharmacy. The public has a similar perception centered on drug (medication) distribution. The dictionary is also among those that primarily identify pharmacies and pharmacists as distributors......
Continue Reading →
Over the last two or three months, we have been observing an accelerating pace of critical news stores focusing the business practices of both the PBM industry and Drug Manufacturers. Now, Rueters is reporting that twenty states are suing Mylan and Teva over drug pricing. Knowing what I do about lawsuits, it will be quite some time before......
Continue Reading →
Among the topics regularly covered on the Thriving Pharmacist are several articles discussing rewards for performance paid to pharmacies. Few of the examples shared here, unfortunately, are actually representative of pay for performance. Today, I will share yet another pay-for-performance program that misses the mark. This program is regional, and is called Intervention Messaging, or IMRx.......
Continue Reading →
This year’s Medicare Part D open enrollment (which ends on Dec. 7th) has turned out to be one of the more interesting  since the program was rolled out more than a decade ago. Previously I reported that our pharmacies elected to drop preferred status with one of the more aggressive plans for 2017. The plan......
Continue Reading →