CVS, which gets discounts and rebates from drugmakers in exchange for listing their products on its formularies of preferred drugs

CVS profit beats estimates; will hold off on new major deals

https://in.reuters.com/article/cvs-health-results/cvs-profit-beats-estimates-as-high-drug-prices-boost-pharmacy-business-idINKBN2062HL

CVS, which gets discounts and rebates from drugmakers in exchange for listing their products on its formularies of preferred drugs, in turn guarantees rebates to its PBM customers. Profits have diminished in the past few quarters as the rate of drug price hikes has slowed under intensifying pressure from politicians of both major U.S. parties.

The company played down the role of rebate guarantees on a conference call with analysts, and said it expects the issue to be immaterial to earnings as it heads into 2021.

“We’ve obviously been working hard to reverse our rebate exposure, and we’ve seen that exposure has lessened in our outlook for 2020,” said Derica Rice, head of CVS’ PBM unit, who plans to leave the company after February.

It would appear that Caremark is ADMITTING that they get discounts/rebates (kickbacks) from the pharmas’ and they “share” that those dollars with its PBM’s customers…

Anthem sues Express Scripts over prescription drug pricing

here is a article where Anthem sued Express Scripts – largest PBM in the country – for about 16.5 BILLION for allegedly charging too much for drugs to Anthem over a 5 yr period.

West Virginia kicked out their PBM for their Medicaid program and is saving 122 million/yr – JUST ON MEDICAID

Arkansas has investigate Caremark – part of CVS – on their state employee health insurance and a survey found that on abt 250 highly prescribed meds that CVS paid a average of $60 more when the prescription was filled  at a CVS store than filled at one of CVS’ pharmacy conpetitors

Ohio has found CVS/Caremark over charging on the HMO medicaid prgms they have in the state.

Kentucky’s legislature is now looking into the PBM handling their Medicaid prgm

Report: Kentucky middlemen reap $123 million from Medicaid at pharmacies’ expense

Last year, pharmacy benefit managers, or PBMs, took in $123 million through a practice known as “spread pricing,” the difference between what the pharmacy benefit company pays the pharmacist and what it bills the state Medicaid program, according to the report.

CVS Caremark, an affiliate of the drugstore chain, holds the majority of pharmacy benefit business in Kentucky.

There examples is just state Medicaid programs but 90% of the Rx in their country abt 3.6 billion/yr are handled by a PBM – and “they” wonder why prescription prices are so high ?

Other countries – like Canada – don’t have these “financial leaches” in their healthcare system and that could explain why Rx prices are less expensive in other countries

 

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