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June 28: Unaccountable Benefit Managers: How PBMs Put Profits Over Over Patients

A young husband was diagnosed with advanced melanoma and tumors attached to his brain. Waiting on the other side of his oncology clinic’s pharmacy counter was a potentially life-prolonging drug. But his Pharmacy Benefit Manager pumped the brakes, instead requiring that he and his wife order the medication from the mail-order pharmacy owned by that [...]

By | 2017-06-28T18:15:44+00:00 June 28th, 2017|News|0 Comments

Patient Denied Meds Due to Technical Glitch

Carl, battling prostate cancer, was prescribed an oral chemotherapy drug to help control his disease. Under his insurance plan, however, the co-pay costs for the medication came to over $4,000 per order. Carl simply could not aff ord to pay such an exorbitant amount. Fortunately, the pharmaceutical company that manufactures the drug has a co-pay [...]

By | 2017-06-27T13:23:11+00:00 June 27th, 2017|Horror Stories|0 Comments

Life-Saving Treatment Postponed

Barbara, who was battling brain cancer, was prescribed two drugs: one a form of chemotherapy and the other an antiemetic that would alleviate the symptoms of nausea caused by the chemo. Both were to be taken in conjunction with the radiation treatments scheduled to begin six days later. At Barbara’s clinic, well aware of the [...]

By | 2017-06-27T13:22:17+00:00 June 27th, 2017|Horror Stories|0 Comments

Medication Delayed 6 Weeks Due to PBM Specialty Pharmacy Indifference

Carol was battling metastatic colon cancer. Unable to receive the same chemotherapy Carol had been treated with initially, her oncologist prescribed a medication to help stop the cancer from spreading any further. Her physician sent all documentation necessary to the specialty pharmacy mandated by Carol’s PBM. One week later, when Carol’s oncologist phoned the PBM [...]

By | 2017-06-27T13:21:25+00:00 June 27th, 2017|Horror Stories|0 Comments

Walgreens combines mail-order pharmacy with Prime Therapeutics

Walgreens Boots Alliance said Monday that it had reached a deal to combine its mail-order pharmacy and specialty drug business with Prime Therapeutics, which will also distribute medicines through the drugstore chain's retail pharmacies. As the nation debates the policy framework that allowed — or even encouraged — drugmaker Mylan to hike the price of life-saving allergy treatment [...]

By | 2017-06-26T16:12:05+00:00 June 26th, 2017|News|0 Comments

Pharmacists on Track to Win Better Protection from PBM Abuses

House Bill 2388 will strengthen the existing regulation of pharmacy benefit managers by giving the Department of Consumer & Business Services the ability to investigate complaints and cancel a company’s registration if the PBM commits fraud or fails to pay civil penalties. Pharmacists appear poised to add significant teeth to the state law regulating pharmacy [...]

By | 2017-06-26T16:09:59+00:00 June 26th, 2017|News|0 Comments

PBM Horror Stories

There is growing awareness of the problems and pitfalls with Pharmacy Benefit Managers (PBMs) in the United States health care system. Contracted by insurance carriers to negotiate on their behalf with pharmaceutical companies, these ‘middle men’ corporations have quietly become an unavoidable part of our nation’s health care system. Controlling at least 80 percent of [...]

By | 2017-06-26T13:30:20+00:00 June 26th, 2017|News|0 Comments

It’s Time to Switch Our Pharmacy Benefit Manager

Express Scripts, the largest pharmacy benefit manager (PBM) in the nation, is discovering just how much customer service matters. It may also be discovering that suing your biggest customer in court is generally not considered good customer service. Should Anthem Inc. withdraw its business from Express Scripts as it has indicated, then clearly the largest [...]

By | 2017-06-26T13:27:21+00:00 June 26th, 2017|News|0 Comments

The ‘Middlemen’ Responsible for High Prescription Drug Prices

The 11Alive Investigators uncover claims of prescription drug price gouging, not from pharmacies, but from a little known industry known as “middlemen” drug suppliers. Those middlemen companies are called pharmacy benefit managers (PBMs). While you may have never heard of them before, pharmacists say PBMs play a big role in the price you pay for [...]

By | 2017-06-26T13:26:44+00:00 June 26th, 2017|News|0 Comments

Drug Costs Too High? Fire the Middleman

Caterpillar’s lowered drug bills show why pharmacy benefit managers are under fire. A decade ago, Caterpillar Inc. looked at its employee drug plan and sensed that money was evaporating. The bills for pills had increased inexorably, so the company started to rein in its pharmacy benefit manager, or PBM. The managers are middlemen with murky [...]

By | 2017-06-26T13:26:01+00:00 June 26th, 2017|News|0 Comments