We Can’t Give Up!

We Can’t Give Up!

https://pharmacistactivist.com/2021/May_2021.shtml

Even in retirement from my faculty responsibilities, my time is fully occupied with pharmacy and other activities to the point that I am challenged to keep up with email communications. As a consequence, I do not participate in or visit social media sites, although pharmacy friends faithfully forward to me social media posts in which they know I will be interested. One such friend who had been terminated by CVS and is pursuing litigation just sent me several hundred comments posted by pharmacists and pharmacy technicians, most of whom work in chain pharmacies. I read them all and they are depressing. They are highly critical of chain pharmacy management, PBMs, state boards of pharmacy, colleges of pharmacy, and pharmacy associations. The comments are characterized by stress, frustration, and even desperation, and I recognize the validity of the concerns that are voiced. As these pharmacists and technicians have experienced, concerns and recommendations I have voiced in numerous editorials have been ignored, rejected, or even ridiculed. However, they and I recognize that the issues and concerns are so important – for pharmacists, our profession, and the care and safety of the patients served – that we must continue the fight. We can’t give up, and the very fact that we continue to voice our concerns is evidence that we still care, even when many of our own colleagues have been silent. Apathy and silence are among our greatest challenges!

Rays of hope

Many of the social media posts address the devastating impact that the pharmacy benefit managers (PBMs) have had on the economic survival of community pharmacies and horrible working conditions that increase the risk of errors and jeopardize the quality and safety of services for patients. The largest PBMs have become so wealthy, powerful, and dominant that they have been able to crush dissent and challenges. However, an increasing number of individuals outside of the profession of pharmacy have become aware of the secret deals, deception, and fraud in which these PBMs are engaged. The persistence of Leslie Rutledge, the Arkansas Attorney General, was essential in achieving a U. S. Supreme Court ruling that supported pharmacy’s position with respect to activities and regulation of PBMs.

“Benefit Managers Investigated” is the title of an article in the May 12, 2021 issue of The Wall Street Journal (Anna Wilde Mathews; page A6). Excerpts from this article are provided below:

“Several states are investigating pharmacy benefit managers with some saying they are focused on whether the companies fully disclosed details about their business and potentially received overpayments under state contracts, according to state officials and documents.”

“States including Ohio, Oklahoma, Georgia, New Mexico, Kansas, Arkansas, and Mississippi, as well as the District of Columbia, are scrutinizing PBMs, according to the offices of state attorneys general and auditors…”

“Among the companies under scrutiny are units of Centene Corp, UnitedHealth Group Inc, and CVS Health Corp.”

Ohio Attorney General Dave Yost’s office which recently sued Centene, alleging it had misled the state’s Medicaid program about its pharmacy related costs, is quoted as saying, “I’m aware of many states that are looking at this” and “before this is all done, I will be surprised if we don’t have a dozen or more states” that will bring complaints against PBMs.

“At many large companies, including UnitedHealth, Centene, Cigna Corp. and CVS, the same parent owns both a PBM and a managed care operation.”

“In addition to Centene, the Ohio Medicaid program uses UnitedHealth, among others. In March, the state filed its suit against Centene, which is seeking millions of dollars in damages. Earlier, the state sued Cigna’s Express Scripts….and UnitedHealth’s OptumRx…,” alleging overcharges.

“Several states, according to publicly available contracts and state officials, have hired the same law firm, Liston and Deas, to investigate PBMs.”

There are rays of hope! Individual pharmacists and our associations must contact these and other state attorneys general to provide examples, documentation, and other support for their investigations.

Daniel A. Hussar

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