@pcmanet In other words, new pharmacies open, get screwed by PBM model and go out of business within few years. Got it!
English
JOSEPH CHAMMAS
497 posts
New data from JAMA: Academic analysis finds independent pharmacies open as frequently as they close: jamanetwork.com/journals/jama-…
English
@UnpopularPharm @ConcernedPharmD @mcuban Here’s a crazy idea: Why not dictate to pharma MFR that they have to sell us that brand name product at the negotiated discount rate?! Why can’t we ALL save money? (Because with the current model pharma get to sell at the high rate and write off the rebate as a loss.. I know!)
English
@UnpopularPharm @ConcernedPharmD @mcuban Ahhh yes.. good old Medicaid. The program that saves the state money while simultaneously screwing the pharmacy. How you ask? By forcing ridiculously expensive brand name drugs over their approved generics. Making us stuck carrying more expensive inventory!
English
What's never discussed is the impact the big 3 drug wholesalers and PBMs have on pricing, More distortion.
In a real market , the wholesalers would compete with each other to get the lowest price from brand drug manufacturers They don't.
Any pharmacies out there want to explain how fucked up the pricing is from wholesalers and what requirements they put on you to do business with them ?
And why you can't just move your business to smaller wholesalers that offer lower prices on generics? Which you could just pass on to patients and companies ?
Matthew Herper@matthewherper
If pharma companies just cut out all those annoying middlemen and sold medicines directly to consumers, wouldn't that cut the prices that people pay? Yes, but... not so much, @elaineywchen finds. Because most consumers' drug costs are mostly covered by insurance, and they don't have hundreds of dollars a month to buy discounted drugs. statnews.com/2025/08/19/dir…
English
@UnpopularPharm @ConcernedPharmD @Blueberryrx That’s the exception to the rule, and a big one at that. You can’t, and shouldn’t, expect all pharmacies to do that. Bad for the public good. They don’t fill everything and don’t take insurance. Let’s actually fix the problem with PBM reimbursement instead of avoiding the issue!
English
@ConcernedPharmD Nothing stopping pharmacies from working without PBMs look at @Blueberryrx
English
Without PBM’s we would have cheaper meds.
No ifs, ands, or buts.
x.com/concernedpharm…
x.com/concernedpharm…
English
"Banning PBMs would hit veterans and rural residents hard. Here's why." nola.com/opinions/guest…
English
🎤 MIKE DROP 🎤
Want to have 72 Shore Points dropped into your MyMike’s account?
How to enter:
🥖 Like this post
🥖 Follow us
🥖 Comment FREE SUB
50 winners will be randomly chosen and reached out to via direct message tomorrow, 6/18. jmikes.co/ShorePtSummer25
English
@UnpopularPharm @InsOligopoly @mcuban @costplusdrugs Ask @mcuban how much of the overall Medicare Caremark patients are using his pharmacy instead of filling either at retail or mail order and using their Caremark coverage
English
@InsOligopoly @JOE_CHAMMAS Ask @mcuban if he’s in their network… he will tell you how great he is doing with @costplusdrugs
English
PBM CVS/Caremark owned by $CVS health, Global Fortune 10 who also owns Aetna pays independent retail community pharmacy $0.36 TOTAL to buy, store, dispense, adjudicate with insurance, counsel patient, maintain liability insurance and store records for 10 years.
Curious what Aetna/PBM bills payor?
Curious what CVS Pharmacy is paid when they dispense.
Is this why CVSHealth decided to close CVS in Arkansas rather than divest of PBM. 🤔
@AAGSlater @AFergusonFTC @MeadorFTC @SecKennedy @DrOzCMS
English
@UnpopularPharm @InsOligopoly Because, as you’re well aware, that’s not how it works. It’s also federal regs (Medicare), not state, that require the 10 yrs of record keeping. It’s also feds (DEA) that have all sorts of controlled substance requirements (states do also). Sadly we don’t get paid either way!
English
@InsOligopoly Many of those requirements are regulatory driven and not something Aetna/caremark force on you. Why doesn’t state government reimburse pharmacy for cost of compliance to their regs that they impose that cost pharmacies $$$?
English
JOSEPH CHAMMAS retweetledi
Sen @HawleyMO is right - PBMs profit off sick Americans.
Under my watch, Arkansas was the first state in the country to ban PBMs from owning pharmacies. Now it’s time for the federal government to follow our lead!
Josh Hawley@HawleyMO
PBMs are buying up pharmacies and putting independent ones out of business It's classic monopolistic behavior—the PBMs get rich while the American people get the shaft
English
JOSEPH CHAMMAS retweetledi
Any revenue cuts that PBMs see from this executive order will be taken out of patients and pharmacies unless there is reimbursement reform. We MUST reintroduce Pharmacists Fight Back and get it passed IMMEDIATELY!
@RepAuchincloss @RepHarshbarger
Matt Stoller@matthewstoller
I'm becoming more skeptical that Trump will do meaningful PBM reform. His OMB official Don Dempsey was the top lobbyist for CVS, which is a major PBM.
English
@UnpopularPharm Yet there is no good reason for the discrepancy. There’s no good reason why it should cost $500 for out of pocket pay in the US while it’s less than $100 in the UK.
English
Also true:
Some (not any and everyone) can benefit from the leverage of the UK to access wegovy at $92 out of pocket.
Some (not any and everyone) can benefit from the leverage of their insurance coverage in the US to access wegovy at $0 out of pocket.
Sen. Bernie Sanders@SenSanders
Last year, I launched an investigation into the outrageous price Novo Nordisk charges for Wegovy. Novo now says it will cut Wegovy’s price for the uninsured from $1,349 to $499. This is a modest step forward. But Novo must do better. Wegovy can be purchased for $92 in the U.K.
English
English
Another congressional hearing on PBM reform, but no real clear policy path forward in sight yet.
Yeah, it feels like perpetual Groundhog Day, but you've got to assume with @RepBuddyCarter in the chair, it's a different field of play this time. @mmcauliff modernhealthcare.com/politics-polic…
English
@UnpopularPharm @tmac622 But we do wish to eradicate what they are now. Maybe they can be genetically modified and become more useful and less harmful. If not, then let them be gone forever!
English
In Alabama we have a saying. They may have it in Texas, too: “pigs get fat but hogs get slaughtered.”
Pharmassists@Pharmassists
Had the PBMs paid independents well, they might have been able to keep their business model. Because of their greed, they are going to feel what we have been feeling real soon. First person I'll email is the Humana rep that denied to pay me better. 😡
English
@HokiePharmacist @UnpopularPharm @RepAuchincloss Yeah they don’t even have a plan on how they would get it back to us. We’re supposed to trust that they’re working on it and they’ll get it right! Yeah.. sure! 👌
English
@JOE_CHAMMAS @UnpopularPharm @RepAuchincloss Pharmacies can't take that cash flow crunch right now. It will close stores
English
Interesting @RepAuchincloss has become a darling to the likes of Indy owners like @HokiePharmacist but in his state… they want to increase the tax on pharmacies to help pay for MassHealth
In Soviet Massachusetts pharmacy pay Medicaid not get better $$!
wpri.com/new-england/ma…
English
@HokiePharmacist @UnpopularPharm @RepAuchincloss It’s beyond insane. They’re basically planning a money laundering scheme of sorts: They take money from us, get matching federal dollars, then give us back the money they took and keep the extra money from the Feds. Completely bonkers! How are we always stuck in the middle?!?😡😤
English
English
@UnpopularPharm @HokiePharmacist @RepAuchincloss Yeah it’s a big mess. Allegedly by levying this “tax” the state will get some matching federal money. We’ve been told they’re planning on giving back that tax money in some other fashion that is yet to be determined. We’re all EXTREMELY skeptical to say the least 🤨
English
@HokiePharmacist @RepAuchincloss @JOE_CHAMMAS I really don’t get the approach lol… if they need that money just cut dispensing fees a buck or make the adjudication fee the penalty.. Medicaid paying pharmacy only for it to get taxed so pharmacy can help pay for Medicaid and around and around we go.
English
@Pharmassists @UnpopularPharm Of course BBC knows.. just loves to always point out the shortcomings of NADAC. I’m sure also realizes that AWP is much worse and the choice is one or the other.
English
@UnpopularPharm Because pharmacies survive on the rare occasion that insurances overpay for drugs. If your U&C is too low, you lose the overpayments and go out of business, because the majority of claims are paid under cost. I think you already know this though 🤔.
English
NADAC is $140 but express scripts pays $27. These guys are fucking thieves! I guarantee they didn't bill the commercial plan the $17 they paid me.
Patient had to go somewhere else.
English
Two more independent pharmacies closed within 10 miles of me. Queue the phone calls for all the people wanting to find a new pharmacy to fill narcotics. Wish I could help. Can't take the chance with how things are now.
English
@MdBreathe Wrong again.. you’re in a roll these past few days with being wrong.. and being an ass!
English
PSA: If a pharmacy tells you they don’t have a medication in stock, it is their responsibility to find another location that has it, not the prescriber. I can’t tell you how many calls a day we get for this problem!
English
@MdBreathe Doctors don’t go to pharmacy school, have limited knowledge of drugs, can avoid responsibility for patient outcomes, hardly spend any time with patients, and most refuse to prescribe ivermectin.
And to suggest making it OTC reinforces how stupid your comments were.
English
Pharmacists don’t go to medical school, don’t have relationships with patients and don’t have responsibility for patient outcomes. Nonetheless, they continue to block ivermectin prescriptions. The best solution is to make ivermectin over-the-counter.
English