Merging toward a monopoly and turning your health into a commodity ?

I got a second letter from Anthem ( Blue Cross/Blue Shield) this week. The first letter was several months ago. IMO.. this letter demonstrates just how Pharmacists, the service that we provide and medication as a whole has become nothing more than a COMMODITY to everyone but the patient… at least those patients that care.

Unfortunately, Anthem using Express Scripts as the PBM and this letter is instructing me that I should move my prescriptions to another pharmacy and that I should consider doing it NOW… “.. before life gets too hectic around the holidays…”

After I got the first letter ( Sept-Oct) , I sent Anthem a email to their customer service saying that I would not be happy if I would be forced to change pharmacies because they could not arrange a fair settlement between Express Scripts and Walgreens… anyone wish to guess the response ??? Their response – at least to date – NOTHING !

Such ARROGANCE.. since I work in LTC, I have to use retail for my Rxs.. and I am sure that they believe that I have no options.. other than pay non-participating rates.. they tell you in the letter this is a option .. with the note that “.. you will have to pay full retail price .. submit the bills yourself … and benefits will be lower…”

What they failed – or could care less about – in June I go on Medicare (A/B/D) and I am sure that Anthem will be filling my mailbox with them wanting me to sign up for the Medicare supplement. Take a guess where those UNOPENED solicitations are going to end up and I already know which Part D provider I am going to sign up for.. and that won’t be associated with Anthem either.

Here is a quote from Dec 9th NCPA executive update

But an even more vivid demonstration of the threat of bare knuckle PBM power was provided by Sen. Herb Kohl (D-Wis.), chairman of the Senate Judiciary Committee subcommittee on antitrust, competition, and consumer rights. Kohl held a hearing last Tuesday provocatively titled, “The Express Scripts-Medco Merger: Cost Savings for Consumers or More Profits for the Middlemen?”

Kohl noted that 42 of the top Fortune 50 companies use Express Scripts, Medco, or CVS Caremark as their PBM. “Reducing the number of competitive choices from three to two raises the dangerous possibility that these large companies will have little choice but to pay more for PBM services,” he said. Then he disclosed that “no large employer who privately expressed concerns to us wished to testify at today’s hearing, often telling us that they feared retaliation from the large PBMs with whom they must do business.”

Think about what an extraordinary statement that is. The very customers of the PBMs—the folks paying the bills—are afraid to speak out! The fact that employers are facing a situation in which they feel relatively powerless should be of extreme interest to the Federal Trade Commission.

Anyone who believes that the Medco/Express Scripts merger will improve anything in our society… except their bottom line. If one looks at Medco’s & Express Scripts annual financial report they each show a net pretax PROFIT of 1.25 BILLION… neither pays a dividend.. To the average stock investor that would suggest that they are using those profits to buy back stock – to prop up their stock price and/or then re-issues those shares and gives them to top brass as a bonus or stock piling cash to buy up competitors and create a monopoly or near monopoly.

The fact that NO LARGE EMPLOYER wished to testify at the hearing… should be a warning to everyone. To me, this sound much like what is described with “mob protection/extortion” and how the Mexican drug cartels controls competition.

If the FTC/Congress allows this merger to proceed.. then we will continue to have the best government/Congress that special interest money can buy.

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