The Vampire Squid, of course……….The PBMs. Put Pharmacy in place of the Earth in the image above.

Dallas Business Journal: Payment system stymies DFW independent pharmacies

August 27, 2012 Medicaid, News

A new payment system in Texas is squeezing independent pharmacies with reduced dispensing fees and lower reimbursements for prescription drugs.

The Dallas Business Journal reports that with pharmacy benefit management companies (PBMs) are now setting reimbursement rates and dispensing fees, Texas Medicaid dispensing fees have been cut by 80 percent, from $7 to less than $2.

According to independent pharmacist Ronald Barrett, Every day, I have to make a decision about whether to fill a prescription because frequently the reimbursement the cost of the drug and our dispensing fee is actually less than we pay for the cost of the medicine. Thats not on every single drug, but it happens enough that its scary.

Barrett goes on to explain that hell typically take a loss on one drug if hes making a profit on another drug the customer is buying. But if the loss-inducing drug is the only prescription the customer is filling, hell decline the business and suggest that they go elsewhere.

Theres an inherent conflict of interest in this system because PBMs are frequently both paying claims and filling prescriptions. The fear is that PBMs are setting unrealistically low prices to force many independent drug stores out of the program and in some cases, force them out of business altogether.

The sad fact of the matter is that its frequently in the best interests of PBMs to follow these practices, or as Glenn Staley, partner in Acorn Pharmacy in Dallas, puts it: They have a built-in incentive to destroy their competition.

9-1-12 ”The Vampire Squid” is no different than the big banks that almost put the USA into a depression. All they do is move money. They provide no medical care whatsoever. They drain probably 18% right off the top. They pay their overhead and deposit the balance. The PBMs take billions of dollars from our industry and we just lay back like fat hookers and let them stick it to us. How did the industry allow them to insinuate their banks into the middle-man position? Pharmacy is not the PBM’s industry.

Mail order. What the !**@!? Read the temperature requirements in the USP. 78 degrees is the max. Drugs kept at temperatures above 78 degrees are “adulterated”. How many mail order envelopes sit for hours in a closed truck in the sun? The temperature could get higher than 120 degrees in a matter of minutes. Then, the package could sit in a mailbox in the sun for a couple days. The APhA’s stated mission is: ”Improving Medication Use. Advancing Patient Care.” Okay APhA, time to !**@! or get off the pot. Medicines kept at a temperature over 78 degrees does not Improve Use or Advance Patient Care. Here is a political piece of !**@!.

Take a look at a box of lanatoprost Ophth 0.005%, Greenstone. ”Important information for mail-order patients. Contact dispensing pharmacy if prescription is not received within 8 days of dispensing date”. Then ”During shipment to the patient, the bottle may be maintained at temperatures up to 104 degrees F for a period not exceeding 8 days”. Why do we keep this stuff in the refrigerator?

A few months ago, a technician failed to put a filled Rx for lantanoprost Ophth Soln in the refrigerator. She put it in the regular filled Rx bin. The patient noticed and refused the Rx. He had me filled it again with a fresh box from the fridge.

We can kill Mail-Order, you guys. Google “Pharmacists United for Truth and Transparency”. I sent them $100.00. I am a two day a week pharmacist. If I can afford to send $100.00 to go after “The Vampire Squid”, you can afford $50.00. Less than the cost of a good meal in a nice restaurant. Jay Pee