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Florida’s Rx drug supply chain needs fixing, more transparency

The Floridian November 6, 2019 Yesterday, the Florida Senate met in two separate committees to discuss the issue of Pharmacy Benefit Managers (PBMs) in the prescription drug supply chain. Both meetings had diverse panels representing the various interests in the matter as they attempted to move toward reform. The Senate Committee on Health Policy met in the morning with four panelists from the Small Business Pharmacies Aligned for Reform (SPAR), Coalition of State Rheumatology Organizations, Pharmaceutical Care Management Association, and Florida Association of Health Plans Inc. They discussed issues including transparency, contracting, payments, steering, and clawbacks. Independent pharmacist, Kevin Duane, stated that the inefficiencies of the PBM process have an eventual effect on the health of the patient. Over the past […]

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Florida Pharmacists Sounding the Alarm, Accuse PBMs of ‘Hijacking’ Health Care Spending

Florida Daily October 30, 2019 With Americans continuing to be impacted by the spiraling costs of health care, some neighborhood pharmacists across Florida have an idea to do something about the growing problem. Pharmacists across Florida have banded together to push for reforms to add more transparency to Pharmacy Benefit Managers (PBMs) which, the pharmacists insist, are driving up costs. PBMs originally came into existence to be a helpful “middle man” between pharmaceutical companies, insurers and local pharmacies. They were initially designed to control costs and negotiate savings which would allow pharmacists to spend more time advising customers, making deliveries when needed and working out payment arrangements for struggling patients. But in recent years, the PBM process has grown into a full-blown, […]

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Trump wants lower prescription drug costs. Florida lawmakers should make the market more competitive

The Capitolist October 9, 2019 President Donald Trump visited Florida last week, making a stop at The Villages, one of the highest concentrations of American citizens who depend heavily on prescription medications. During the stop, he highlighted one of his highest priorities: making prescription drugs affordable for all Americans. One of the fastest ways to make that happen requires bold action in Tallahassee, and it’s needed sooner rather than later, because independent pharmacies are closing all across the state of Florida, giving rise to large chains that dominate the market, restrict consumer choice, and remove competition from the price equation. Worse, current public policy is slowly, but inevitably encouraging a shift toward an eventual oligarchy controlled by a small number of […]

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Forget Canada, Florida has a home-grown fix for Rx prices

Florida Politics March 5, 2019 Gov. Ron DeSantis recently pitched the idea of importing prescription drugs from Canada to help out Floridians getting raked over the coals during their monthly trip to the pharmacy. It sounds like a fine plan on its face, but there’s a loaf of logistics that need to be ironed out before Canuck capsule can be doled out to Florida patients. That’s not to say it couldn’t happen — the Department of Health and Human Services (HHS) has had the authority to allow importation from Canada for more than a decade — but it would take policy changes at the federal level in order to get the ball rolling. And that’s something the Trump Administration isn’t exactly keen on doing. Even if […]

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Watchdog: Insurance Groups Buy Drug “Middle Men”; Transparency Calls Grow

Spectrum News 13 July 23, 2019 PBMs: have you heard of them? If not, you’re not alone, but they do factor into your prescription drug costs. They’re essentially a “middle man” between drug makers, health care plans, and patients, negotiating the prices most of us pay for prescription drugs. n the last two years, health insurance companies, which set deductibles and co-pays, have bought up the three main PBMs: Express Scripts, CVS Caremark, and Optum RX. A number of independent pharmacies have told Spectrum News they are now losing business and revenue because of PBMs, including Five Points Pharmacy in Cocoa, a pharmacy that has been welcoming customers since 1958. Louella McCormick Edwards started coming to 5 Points Pharmacy with her mother. […]

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Independent pharmacies being driven out of business by ‘predatory middlemen’ | Opinion

South Florida Sun Sentinel October 21, 2019 Lately, everywhere you look there are people worried about keeping drug prices affordable, especially for Florida’s aging seniors. People are voicing their concerns, but many are ignoring one of the biggest factors contributing to reduced access and increased costs — and sometimes driving people like me out of business. Pharmacy Benefit Managers, or PBMs, have been abusing their power for years, remaining undetected as they drive independent pharmacies into the ground. These predatory middlemen no longer serve their original purpose of negotiating medication savings for patients. Instead, they use their corporate clout to force patients to certain pharmacy chains. This drives up costs for everyone while the PBMs pocket profits. This national issue […]

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Jackie Toledo plans to tackle prescription drug prices by regulating the middleman

Florida Politics December 9, 2019 Rep. Jackie Toledo plans to file legislation this week that would lower prescription drug prices for some consumers and protect small pharmacy owners by regulating what are known as pharmacy benefit managers. Pharmacy benefit managers, or PBMs, serve as middlemen between pharmacies and health insurance companies to provide real-time benefit analysis and actual costs for consumers purchasing prescription medication. These individuals are meant to make it easier for pharmacies to obtain health insurance benefit information on patients so they can get their prescriptions in a timely fashion, but their presence has morphed into what some believe is a profit-driven model that favors insurance providers and large pharmacy chains over patients.  Continue Reading

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The Secret Drug Pricing System Middlemen Use to Rake in Millions

Bloomberg September 11, 2018 For years, Frahm’s South Side Drug bought pills from distributors, and dispensed prescriptions to the Wapello County jail. In turn, the pharmacy got reimbursed for the drugs by CVS Health Corp., which managed the county’s drug benefits plan. As he compared the newspaper notice with his own records, and then with the county’s, Frahm saw that for a bottle of generic antipsychotic pills, CVS had billed Wapello County $198.22. But South Side Drug was reimbursed just $5.73. So why was CVS charging almost $200 for a bottle of pills that it told the pharmacy was worth less than $6? And what was the company doing with the other $192.49? Frahm had stumbled across what’s known as […]

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