KP, Pharm.D.

Story Time: Buckle up for this one.

Patient called today pissed off. They weren’t pissed at me, more so pissed at their insurance company @DevotedHealth and @CVSHealthPBM

For the past month, @DevotedHealth has been pestering them about switching their medications over to their mail order @CVSHealthPBM

First it was atorvastatin and Jardiance, because they said the patient would have “cheaper” copays.

The patient called us to verify those prices.

Our prices were identical to what they would have paid at mail order.

Patient told @CVSHealthPBM NO!

They wanted to stay local.

A few days later, patient gets a message from @CVSHealthPBM stating they had two prescriptions waiting to be sent to the patient. Just needed the go ahead to mail them out.

It was for the same 2 prescriptions they had said no to a few days prior.

Patient called them back and told them no, they want to continue getting them locally…. That was the end of it.

Until today…

Patient called back and said now @CVSHealthPBM has another prescription for metformin ready for me and has already mailed it out.

It’s a prescription we have been filling at our independent pharmacy all of this calendar year at a $0 copay.

Patient told them, I didn’t authorize you to get this prescription ready for me at mail order, how did you receive the prescription?

@CVSHealthPBM told them that their Dr. had authorized a new prescription for them.

Patient calls their Dr.

Dr. states they never sent a prescription to mail order @CVSHealthPBM

So, let me sum this up and put a nice little bow on it for you:

@CVSHealthPBM requested a new prescription from patient’s Dr. without their consent.

@CVSHealthPBM prepared the new prescription for patient without their consent.

And finally, @CVSHealthPBM mailed out the prescription for the patient without their consent.

I don’t know who is ultimately at fault for this, but it’s damn sure not the patient…

The patient keeps saying NO, but @CVSHealthPBM says we don’t give a shit, we’re going to do it anyway.

@CMSGov @DrOzCMS @RobertKennedyJr @realDonaldTrump

So David Joyner at @CVSHealth has stated multiple times that independent pharmacies are actually paid MORE than they pay their own pharmacies.

He’s obviously full of shit.

Just ran a drug plan comparison on Medicare for 30 tablets of bupropion xl 150mg.

Independent pharmacies are paid $4.49

Discount Drug Mart is paid $4.49

Kroger is paid $4.49

Walmart is paid $11.92

CVS IS PAID $32.53

This is through their @SilverScriptPDP Medicare Part D plan.

Get out of here with your bullshit, David Joyner.

Honestly getting sick and tired of seeing posts like this.

But @pcmanet and other PBM lobbyists have a shit ton of extra money lying around to post anonymous shit like this.

@HawleyMO @SenWarren

The Break Up Big Medicine Act would finally put an end to the corruption of the insurance monopolies that have been destroying access for millions of Americans.

CMS is actively destroying independent physicians just like they are actively destroying independent pharmacies by sitting on idle for years not regulating PBMs.

We need to codify pharmacies getting paid in a more efficient way than how it is currently.

Why are we expected to float medication costs for 5-6 weeks waiting for our payments.

Our wholesaler payments are due every 14 days.

At any given time, we could be waiting on $5k, $10k, $20k, etc depending on what we dispensed that month.

Why are we expected to bankroll patient medication costs at ZERO PERCENT INTEREST?

We aren’t @Optum. We don’t own our own bank.