During this difficult time in our world, ask yourself this, why everyone is struggling yet health insurance companies, aka PBMs, are posting record profits!?
Joined August 2017
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PBMs BE GONE retweeted
I want thank Congressman Mark Pocan for agreeing to co- sponsor HR 9096. He is the first WISCONSIN elected official to step up to the plate for the pharmacist backed act. #PBMReform #pbm #fyp @MarkPocan @TruthRX @RepGrothman
PBMs BE GONE retweeted
They need to be worried about all the federal investigations and people of America fed up with their unethical acts and lying under oath, saying that they don't steer to their own pharmacies.
PBMs BE GONE retweeted
Proof of perjury by the PBM executives. Fair reimbursement shouldn't even be a fight anymore. We have all the evidence but no action 🤔.
xitter.cf/redlgb1969/status/1845…
PBMs BE GONE retweeted
CVS Caremark and the other big three PBMs have got to be admired. These are
companies so powerful they lobby the federal government for permission to rob them, and receive it.
@pcmanet @cvspharmacy @CVSHealth @OptumRx @ExpressScripts
PBMs BE GONE retweeted
Express Scripts is suing the FTC, accusing them of releasing false and misleading claims about the PBM industry.
Within its case, ESI relies heavily upon a new analysis dubbed The Carlton Report.
After reviewing the report, we’ve got some things to say. 46brooklyn.com/news/2024-09-…
PBMs BE GONE retweeted
I'm a little busy putting on protests at PBM headquarters, finding cosponsors for HR 9096, making statements at committee hearings, organizing pharmacists to target bottlenecks holding up state legislation, keeping my store afloat, raising a one year old little girl, hosting an industry podcast, and numerous things I can't publicly talk about. But sure, when I want to waste my time in a scope of practice circle jerk, maybe APhA might be worth my time.
PBMs BE GONE retweeted
Congrats @ArthritisSTL Julie Baak winner of 2024 Advocate of theYEAR!@HokiePharmacist @mcuban @MattieRheumMD @GetClaimable @wendellpotter @BoesingLoretta @CSROAdvocacy
PBMs BE GONE retweeted
"Fooled", lol they were never fooled only given a plausible excuse to let them off so they can collect $$$ somewhere else. Guaranteed.
PBMs BE GONE retweeted
I was thinking @cardinalhealth bought Outcomes many year ago. Not 100% sure though
PBMs BE GONE retweeted
My comments at the FTC meeting this morning:
PBMs were given a market advantage via a kickback exemption that is being leveraged up and down not only the drug pricing chain, but the entire healthcare industry.
Within vertically integrated PBMs, these rebates act as a fulcrum during negotiations in ways it was never intended to.
When coupled with the opaqueness of their "proprietary" drug pricing, rebates act as cover for healthcare conglomerates to move money from one hand to the other to avoid scrutiny.
It is the primary mechanism in a shell game that is destroying the pharmacy and healthcare infrastructure of this country.
PBMs drive the cost of medication up and price gouge plan sponsors in a coordinated and complex way, as demonstrated in the 3 Axis and interim reports.
To perpetuate this scam, conglomerates make it cost inhibitive for plan sponsors to opt out of the PBM mail order plans, forcing patients into their corporate silo and leaving smaller pharmacies, plans, and PBMs unable to compete.
PBMs present this fraud with misleading metrics that imply “savings” for plan sponsors that are anything but.
Conglomerate power and control of the system leave pharmacies helpless when presented contract terms featuring underwater reimbursement rates, predatory fees and recoupment methods, and a forced arbitration clause that demands pharmacies arbitrate individually at a cost of over six figures if they wish to challenge reimbursement.
If pharmacies say anything about these abusive terms to the media or plan sponsors, they are threatened to be removed from conglomerate networks.
Vertically integrated conglomerates are selling non-solutions to problems they create in a deceptive and forceful way.
This is the most complex case of racketeering in the history of our country.
No entity should be given a market advantage with little to no oversight or accountability, especially when it has been proven to be so thoroughly abused
I call upon the FTC to seek elimination of the PBM and GPO kickback exemption, enforce the Robinson Patman Act to ensure transparent drug pricing and sustainable reimbursement, and negate the arbitration and gag clauses of PBM contracts so that pharmacies can demand in court that they be made whole.
#Pharmacy #TwitteRx
PBMs BE GONE retweeted
Great explanation of the PBM mess
My comments at the FTC meeting this morning:
PBMs were given a market advantage via a kickback exemption that is being leveraged up and down not only the drug pricing chain, but the entire healthcare industry.
Within vertically integrated PBMs, these rebates act as a fulcrum during negotiations in ways it was never intended to.
When coupled with the opaqueness of their "proprietary" drug pricing, rebates act as cover for healthcare conglomerates to move money from one hand to the other to avoid scrutiny.
It is the primary mechanism in a shell game that is destroying the pharmacy and healthcare infrastructure of this country.
PBMs drive the cost of medication up and price gouge plan sponsors in a coordinated and complex way, as demonstrated in the 3 Axis and interim reports.
To perpetuate this scam, conglomerates make it cost inhibitive for plan sponsors to opt out of the PBM mail order plans, forcing patients into their corporate silo and leaving smaller pharmacies, plans, and PBMs unable to compete.
PBMs present this fraud with misleading metrics that imply “savings” for plan sponsors that are anything but.
Conglomerate power and control of the system leave pharmacies helpless when presented contract terms featuring underwater reimbursement rates, predatory fees and recoupment methods, and a forced arbitration clause that demands pharmacies arbitrate individually at a cost of over six figures if they wish to challenge reimbursement.
If pharmacies say anything about these abusive terms to the media or plan sponsors, they are threatened to be removed from conglomerate networks.
Vertically integrated conglomerates are selling non-solutions to problems they create in a deceptive and forceful way.
This is the most complex case of racketeering in the history of our country.
No entity should be given a market advantage with little to no oversight or accountability, especially when it has been proven to be so thoroughly abused
I call upon the FTC to seek elimination of the PBM and GPO kickback exemption, enforce the Robinson Patman Act to ensure transparent drug pricing and sustainable reimbursement, and negate the arbitration and gag clauses of PBM contracts so that pharmacies can demand in court that they be made whole.
#Pharmacy #TwitteRx
PBMs BE GONE retweeted
Is there a penalty for lying to @GOPoversight? I was glad when @RepJamesComer stopped the hearing when big #pbm told a pants on fire whopper that they have a good relationship with indie pharmacists. He reminded them they were under oath.
I recall the CVS PBM CEO stating during the congressional @GOPoversight @OversightDems hearing that CVS passes "99%" of rebates back yet now is paying one state $45 million to settle a lawsuit that rebates are not passed along. Perjury?
drugtopics.com/view/cvs-pbm-…
PBMs BE GONE retweeted
I asked the CVS Caremark CEO how much he’s charging for a $16 drug for multiple sclerosis.
Answer: $6,229.
Yeah, that‘s a 38,000% markup from this Fortune 10 PBM.
PBMs BE GONE retweeted
Thought we lived in a free country? @FTC @mcuban @SenateDems @SenateGOP why does @cvspharmacy FORCE customers to use THEIR #PBMabuse for a better price?! How is this a fair market?! Pharmacies will close daily until you FIX this!! Help now!!
PBMs BE GONE retweeted
What it’s like to be in healthcare right now:
“We will pay you $2 for that pie”
“But it costs me $4 in pie ingredients and $2 in human labor to make a pie. We need $6 to break even”
“Sorry, we’ll only pay you $2 for that pie. We suggest you make many more pies that you also sell for $2/pie. New requirement is 6 pies/day”
“But then we are still losing $4 per pie. How does making more pies help us?”
“We just found out flour is on shortage so you’ll have to buy more expensive imported flour and will lose $5 per pie. Or you can consider making pies without flour.”
“But I can’t make pies if we keep losing money on pies. And I can’t make pies without flour”
“We suggest you ditch rolling pins and remove any fruit filling as a cost saving measure. And consider limiting how much time you bake the pie for to use less oven time”
“But then how can I even make a pie that resembles a pie?”
“We appreciate the question and have no response. We empower YOU to solve this problem. We have scheduled 4 meetings to discuss how you can make more pies with less ingredients and less oven time and less labor”
“But it seems the root of the problem here is actually that we don’t get reimbursed fairly for our pies…”
“Don’t say that out loud. Please get back to making pies with no filling and no flour and no rolling pins and be sure to attend the meetings.”
#medtwitter #Pediatrics #insurance
PBMs BE GONE retweeted
As a former newspaperman, I would have loved to have gotten a hard copy of yesterday's @nytimes. There's nothing like a good exposé above the fold on A1. #PBMReformNow
ALT The front page of the New York Times from June 23, 2024, featuring an in-depth article on how pharmacy benefit managers artificially inflate prescription drug pricing
PBMs BE GONE retweeted
My name is Loretta Boesing, and I am a #mother on a mission—a mission to protect my child's life at any cost. When my son received a gift of life from a 3-year-old little girl our lives were forever changed. But amidst the chaos and despair, one thing became abundantly clear: I would move mountains to ensure he and others received the life-saving medications they needed safely.
Not long after my son received his gift of life, I would be introduced to the shadowy world of Pharmacy Benefit Managers (#PBMs) that manage pharmacy benefits for insurance companies and force many to their own mail order pharmacy. The largest three are #OptumRX, #CVS Caremark, & #ExpressScripts. Their bureaucratic maze and profit-driven motives stand as barriers between patients like my #son and the #medications that could mean the difference between life and death. But I refuse to let them dictate their fate.
I embarked on a relentless crusade, researching tirelessly, advocating passionately, and speaking out loudly against the injustices perpetrated by these corporate giants. When faced with risks of delays and interruptions in treatment, I refused to stay silent, sharing my family's story with anyone who would listen, shining a spotlight on the horrors inflicted by PBMs.
But my fight didn't end there. I knew that even if we managed to navigate the labyrinth of #PBMs, there were still dangers lurking—improper temperature storage, logistical nightmares, and the impersonal nature of the PBM system. PBMs also oversee reimbursements to local pharmacies and frequently reimburse them purposefully below their cost to the point that 30% of America's locally owned pharmacies are expected to close. So I made it my mission to champion local pharmacies, recognizing the invaluable role they play in providing personalized care and support to #patients like my son and America's #publichealth.
Through sheer determination and unwavering advocacy, I succeeded in securing safe access to the medications my son desperately needs. His suffering was spared for now, but that's not the case for so many others trapped by this monopolistic system. I want to see a future of pharmacy and medication access that will be filled with hope and promise. I refuse to back down in the face of injustice.
My story is a testament to the power of a mother's love, the resilience of the human spirit, and the impact that one person can have when they refuse to accept the status quo. And while my journey may have been fraught with challenges, it has also been filled with moments of triumph—reminders that even in the darkest of times, there is always hope and real-life heroes that fight alongside us.
So let us stand together, united in our commitment to justice, demanding an end to the many abuses of PBMs and a future where safe access to #healthcare #medications & local pharmacies is a fundamental right, not a privilege reserved for the few.
Thank you to every person standing with us in this fight—for my son, for every patient who has been failed by this broken system, and for a future where compassion triumphs over greed.
Please joins us the Express Scripts Protest On May 17th 2024. uniteforsafemedications.com/…
Much love to all of our supporters. Happy #MothersDay to all. Our hearts go out to those who are grieving the loss of children, mothers, and motherly figures in their life.
