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Pharmacy Benefit Managers Are the Real Reason Behind Skyrocketing Drug Prices

Grit Daily – April 30, 2020 Why are drug costs so high in America? If you ask Bernie Sanders, he will tell you that it’s due to the greed of the pharmaceutical industry. If you remember when “pharma bro” Martin Shkreli, former CEO of Turing Pharmaceuticals, made the price of the life saving drug Daraprim 5,000% higher overnight, you may agree with this assessment. But, there is more to the story, and it has to do with Pharmacy Benefit Managers (PBM’s). Within the healthcare industry, there are pharmaceutical manufacturers, pharmacists, insurance companies, and Managed Care Organizations (MCO) for Medicaid, but there is one more player that few outside of the industry discuss—the pharmacy benefit manager, or PBM. A PBM’s original role was […]

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Neighborhood pharmacies struggle to stay open due to PBM restrictions

Tampa Bay News 10, July 9, 2020 So far, at least 8 independent Tampa Bay pharmacies have shut down because of challenges with Pharmacy Benefit Managers (PBM). As COVID-19 cases skyrocket in Florida, we’ve talked a lot about what doctors’ offices are doing, but what about pharmacies? Whether you realize it or not, your pharmacy options are becoming more limited but not because of COVID, but from something called Pharmacy Benefit Managers, or PBMs. It’s a big enough problem that one Tampa lawmaker is working to pass a bill to protect independent pharmacies and demand transparency. “Our motto here at Bill’s Prescription is to treat people like family,” pharmacist and owner of Bill’s Prescription John Basil Noriega said. Noriega’s family […]

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Independent Pharmacists Stress Personal Touch In An Industry Dominated By Chains

The Town Crier, February 28, 2020 On Wednesday, Feb. 19, the advocacy group Small Business Pharmacies Aligned for Reform (SPAR) hosted a press conference at My Community Pharmacy in Wellington regarding pharmacy benefit managers (PBMs) and their effect on pharmaceutical pricing. Speakers at the event outlined what they called “shady” practices in the PBM industry that aims to put independent pharmacies, such as My Community Pharmacy, out of business. The pharmacy is located at 2615 S. State Road 7 near Whole Food Market in Wellington, owned by Johnny Meier, one of the speakers at the event. In attendance with Meier were other local, independent pharmacists, customers and Wellington Mayor Anne Gerwig. Several speakers addressed the problems involving pharmacy benefit managers — […]

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Opinion: Your local pharmacy is at risk of going away

83 Degrees, July 14, 2020 Tampa summers are typically the “slow season” for local pharmacies. But during COVID-19, nothing is typical nor should be taken for granted. The coronavirus pandemic coined the term “essential workers” and your local pharmacy is obviously essential, right? Pharmacies are always open, even in a public health crisis. Of course, they’re open, why wouldn’t they be open? Pharmacies are always there when people need them. But what happens if your local pharmacy can’t be there for you? Opinion column by Pharmacist Alex HerwigA recent survey among Florida independent pharmacies shed light on a little-known, but critical issue. Intended to examine the viability of Florida’s Medicaid managed care model on local pharmacies, the survey instead uncovered […]

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Data Proves PBM Industry Maximized Profit At Patient Expense

Cision Newswire, June 15, 2020 Physicians and Patient Advocates Call for More State Disclosures The Alliance for Transparent and Affordable Prescriptions (ATAP) reacted today to a report issued by the Texas Department of Insurance (TDI) showing the financial activity of the pharmacy benefit manager (PBM) industry in the Lone Star State. Texas law requires that PBMs annually report to the Insurance Commissioner aggregate data on rebates. “The Texas rebate report is unambiguous. The PBM industry has been generating significant profits while patients struggle to afford the cost of prescription drugs,” stated ATAP’s President Dr. Robert Levin. “Since 2016, through a complex rebate and price concession, the PBM industry in Texas pocketed more than $350 million in revenue, while passing a mere $16 million in savings to enrollees.” The data as reported […]

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Okeechobee pharmacist demands ‘special session on drug pricing reform’

NBC WPTV 5, February 13, 2020 A popular pharmacist is calling for prescription drug pricing reform in Florida after a newly released report shows small pharmacies are having a difficult time competing with corporate giants and some in our region fear they will have to close their doors. For decades JoAnne White has chosen Okeechobee Discount Drugs for the savings and the people. “The prescriptions are just ridiculous,” said White. “If [this drugstore] goes out of business and I have to go to one of these others – I don’t know what I’ll have to do.” On Thursday, White and other customers stood in the drugstore – not for prescriptions – but to draw attention to the need for reform. […]

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Shane Abbott: Rural communities most affected by predatory PBM middlemen

Florida Politics, March 8, 2020 Over the past year, I’ve made the drive from my small pharmacy in DeFuniak Springs to Tallahassee dozens of times to advocate for one priority: PBM reform. Unless significant reforms are made to Florida’s broken PBM system, patients will be put at risk due to lack of access to prescription drugs — especially those who live in smaller, more rural communities like mine. Local pharmacies have been under attack for some time by predatory middlemen called pharmacy benefit managers or PBMs. The three largest PBMs control 85% of the prescription drug market and, together, these operators are driving neighborhood pharmacies out of business. This is not a situation like Blockbuster and Netflix where local pharmacists […]

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Alex Andrade tackles Rx drug legislation, but does it go far enough?

The Floridian, February 21, 2020 Florida state Rep. Alex Andrade (R) is advocating for a bill that would create more transparency around the prescription drugs that Floridians buy. But some groups are questioning whether it goes far enough. This week, Rep. Andrade presented his bill about prescription drugs to the House Health and Human Services Committee. The bill, HB 7045, addresses a number of different aspects including creating advanced notice requirements for drug price increases and requiring new reporting standards for certain entities in the prescription drug market. However, critics point out that the bill does not fix one issue that many consider is the biggest issue facing prescription drug supply chains, which is pharmacy benefit managers or PBMs. In a recent […]

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Local pharmacists complain drug middlemen hurt patient prices and business

Citrus County Chronicle February 12, 2020 In the competitive pharmaceutical industry where drug manufacturers vie for huge market shares, middlemen work billion dollar deals, and pharmacy goliaths dominate the prescription landscape, it’s hard to be small, and, in many cases, unfair. That’s the take by Jesse Brashear, of Brashear’s Pharmacy in Lecanto and Inverness, and who is hoping proposed legislation that requires more transparency about drug prices. Brashear’s focus during a local press conference Wednesday was predominately on pharmacy benefit managers and House Bill 961. Brashear said pharmacy benefit manager middlemen who work out drug prices between pharmacies and insurance payers often favor large chain pharmacies or pharmacies they own, leaving small, local pharmacies to wither pacing far lower reimbursement […]

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Study finds millions in Medicaid unfairly pocketed by Pharmacy Benefit Managers

The Capitolist February 4, 2020 A new Florida study, released last week, found that major health care companies using pharmacy benefit managers (PBM’s) have positioned themselves to pocket millions of dollars from the state’s Medicaid system that were intended to lower costs for millions of low-income Floridians. The study found that despite processing less than half of one percent of all pharmacy claims, specialty pharmacies affiliated with PBM’s managed to collect 28 percent of the available profit margin from dispensing prescription drugs. The study was commissioned by the Florida Pharmacy Association and American Pharmacy Cooperative Inc. using data obtained from Florida’s Agency for Health Care Administration (AHCA) by the Small Business Pharmacies Aligned for Reform.  Smaller pharmacy operators say the report […]

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