HARMACY

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I still do not understand why, in the American healthcare system, when a doctor orders a prescription, he cannot give you the medicine directly. You must instead stand in line for 45 minutes at a pharmacy several days later to get it.

Clinic is getting really exhausting because no one can afford meds any longer. And look. I get it. My patients tend to cluster at low socio-economic, lower IQ, and lower life skills. But still God’s kids. All of them. Breathing easy is precious. You take it for granted.

All personal information on this bottle has been redacted. I was grateful Publix filled this prescription this month after paying nearly $400 for months at one mom-and-pop pharmacy, followed by $160 at a different mom-and-pop pharmacy last month. $40 felt like oxygen. And then, at the Publix pharmacy counter, while handing me this prescription, I was told that starting next month, Publix will no longer accept my pain management doctor. CVS already said no. Walgreens already said no. What we’re watching isn’t safety. It’s stratification. Access to pain care is disappearing for Middle America, while those with money, influence, or concierge medicine remain insulated from these barriers. This is a two-tier system: retail denial for ordinary patients, private access for the powerful. This isn’t about misuse. It’s about access. And access is disappearing, selectively.

So, what are the options for independent pharmacies? Stop carrying these drugs altogether? That won’t work once more and more drugs are added to the program- there won’t be anything left on our shelves to stock after a few years. Send it to mail order? PBMs own the majority of mail order pharmacies, so they don’t mind taking more of our business. Send it to another retail pharmacy down the street? Maybe, unless they don’t carry them either… Usually in a negotiation, parties are in some sort of mutual agreement. Small pharmacies didn’t get a say in these negotiations. We were required to enroll into the program to continue serving Medicare patients. Didn’t matter if you weren’t stocking the drugs or not, if you accepted Medicare Part-D and Medicare Advantage, you had to at least enroll regardless if you actually used it. Hell, @CVSHealth even required us to attest to them that we did enroll into the MTF program after actually doing it. Who decided it should be financially placed into our laps to make this program succeed? @CMSGov @DrOzCMS @realDonaldTrump

We have multiple patients at multiple assisted living facilities on Eliquis, Jardiance, and other “discounted” federal drugs who have copays for 100s of dollars and can’t afford their “discounted” medicine. As predicated by pharmacists, the plan is not working for who actually needs the help - the patients!! Pharmacies fill the medication at a huge loss until we get “rebates” and patients still can’t afford their meds. Who is winning in this scenario???? 😡

We haven't been paid for any Xarelto Rx's since the MFP system started. The 14 days the manufacturer has to pay us is up today. We have over $14k tied up in this bullshit MFP process. Wheres fucking @pharmacists fighting on our behalf? Hope @mcuban can help us publicly shame these slacking manufacturers (except Merck, they cool). We went from being paid negative dollars for these products to them holding our money hostage while the wholesaler wants to get paid. Again, pharmacy is stuck being the fucking fall-guy of the medical world.

Arkansas was the first state in the nation to ban PBM’s anticompetitive actions. Now, Congress has found that CVS Caremark - one of the largest - may have violated federal law. It’s time to hold these companies accountable. thehill.com/homenews/56978…

OptumRx President on why high-cost brands are preferred on its formularies over more affordable generic alternatives: 1/3

If someone were paying me millions of dollars a year, I would try and play dumb answering questions I should know the answer to, too! Hearings involving PBMs at the state or federal level are just political theatrics at this point given the plethora of bad press and hard evidence surrounding PBMs. How many more hearings (grilling) of CEOs are needed? 10 more, 25 more, 100 more?

House panel finds CVS may have broken antitrust laws by threatening independent pharmacies from using money saving services outside the CVS PBM network. @GovSherrillNJ @njassemblydems @NJSenDems @senatorvitale @SpeakerCoughlin @SenPresScutari thehill.com/homenews/56978…

"The vertical integration — you guys own PBMs, you own pharmacies, you own health agencies, physician groups. Good God, you own a bank! Why would an insurance company own a bank?" @RepGregMurphy calls out insurance CEOs and calls for Big Medicine conglomerates to be broken up.

The CEOs of the highest profiting health insurance companies are on Capitol Hill today and Democrats' message to them on taking record profits while Americans face higher costs…"It’s not your fault" I look forward to my Democrat colleagues and these CEOs' explanation this afternoon.

Good stuff from @bobjherman & @_daniel_payne on today’s grilling of health insurance CEOs. Lots of deserved blame across the healthcare industry with everyone pointing fingers at anyone but themselves while limp policy reform efforts sputter along. statnews.com/2026/01/22/hea…

Too big to care. Make them divest all non insurance assets. They have thousands of subsidiaries and their intercompany transfers are almost 1 percent of the gdp of this country !

3 health insurance companies control half the market, and 3 pharmacy benefit managers control 80% of drug benefits. Health insurance conglomerates claim market consolidation delivers greater efficiencies, so why are patients paying more for premiums and seeing fewer options, while costs are shifted onto taxpayers?

I asked health insurance CEOs to raise their hands if they’re penalized when patients are harmed by delays or wrongful denials. Not. One. Hand. Patients pay the price. Executives protect the profits. That’s the problem.

Health care monopolies on patient care screw over working families and destroy your ability to access affordable care. All so corporate CEOs, like those from CVS Health, can pad their pockets. We must break up big medicine. We need a Glass-Steagall for Health Care.

It would be beautiful to see a massive class action lawsuit against PBMs where pharmacies were forced to close b/c of @CVSHealth behavior. I would reopen my pharmacy with the settlement.

🚨 Albertsons vs. Express Scripts: The $10M Battle Exposing the PBM Problem Think your local pharmacy is just a place to pick up pills? It’s actually a battlefield. Albertsons, the 10th largest pharmacy chain in the US, has officially sued Express Scripts, a massive Pharmacy Benefit Manager (PBM). Here’s why this matters to every American with a prescription: 📑 The Allegation: Secret Reclassification Albertsons claims Express Scripts secretly reclassified a long list of drugs from Brand to Generic. Why does that matter? Brand drugs are reimbursed at a higher rate (e.g., $80 on a $100 drug). Generic drugs are reimbursed at a much lower rate (e.g., $60 on a $100 drug). By flipping the switch without notice, Express Scripts allegedly shortchanged Albertsons by $10 million. 📧 The "Auto-Response" Nightmare The lawsuit reveals a pattern of behavior many independent pharmacists know all too well: Albertsons spent weeks preparing detailed audit documents. Express Scripts responded in minutes, asking for info that was already in the first email. Months of back-and-forth ended with Express Scripts claiming the "reconciliation period" had expired. Basically, they ran out the clock to avoid paying what they owed. 🕒 ⚖️ If Albertsons is Struggling, What About Small Pharmacies? Albertsons has $9.5B in annual revenue and the legal muscle to fight back. But most local, independent pharmacies: Can’t afford a $10M loss. Can't afford to sue. Are often locked into arbitration clauses (like CVS Caremark’s) that require a $50k deposit just to start a dispute. 💡 The Solution At Forest Park Pharmacy, we’re done with the PBM nonsense. We focus on transparent pricing and direct-to-patient care. When you cut out the middlemen who manipulate drug classifications, you get better service and fair prices. What do you think? Are PBMs helping the healthcare system, or are they just an invisible tax on your medicine? Let’s discuss below. 👇