It would seem in hindsight, that the war on drugs was mostly built on racism, bigotry and lies.  It has been claimed that the Controlled Substance Act bill was signed into law by a President (“tricky dick nixon) that was known to be a racist/bigot and he wanted to throw blacks and “hippies” into jail. This law was design to deal with the “black drug market” that was created in 1914 by the Harrison Narcotic Act  https://en.wikipedia.org/wiki/Harrison_Narcotics_Tax_Act  This law created the Bureau of Narcotic and Dangerous Drugs  https://en.wikipedia.org/wiki/Bureau_of_Narcotics_and_Dangerous_Drugs  by combining Bureau of Narcotics (Dept of Treasury) & Bureau of Substance Abuse Control (under HHS). Moving dollars committed to deal with narcotic use/abuse/diversion  combined with abt 3 million budget and created the BNDD with a 43 million budget and 1500 agents.  In 1973, the BNDD transitioned into being the DEA.

Today the DEA has abt 10,000 employees – down to 2003 levels and 3.1 billion budget – up abt 50%-60% from 2003. That just tells part of the story, because many cities, counties, states.  Plus prisons (private & gov), our court system ( prosecuting attorneys, defense attorneys, judges & supporting staff ). Over the last 50+ yrs, the war on drugs has become a 100+ billion/yr INDUSTRIAL COMPLEX.

For those of you who believe that trying to talk to your member of Congress and/or getting the local media to cover the denial of care… here is the website for DEA Press Releases https://www.dea.gov/what-we-do/news/press-releases.  JUST TODAY (06/08/2022) the various DEA regional district and/or HQ put out SEVEN PRESS RELEASES to various media sources  – on how the DEA is winning the war on drugs..  A number of years ago – maybe during the Reagan Admin,  some entity within the Federal Gov was charged with making determination of how successful various federal agencies were in meeting their operational charge.  As I remember, the DEA got a GRADE OF ZERO !!!

I started this blog abt 10+yrs ago, just as the prescribing of opiates were peaking. I have seen many advocates come and go… I have seen some non-profits come and go..  I have seen some people who imply that they are part of a non-profit, when they are not..  While most all of these entities profess that they have the same goal, better pain management… but just like a ROAD MAP, there is numerous ways to get from point A to point B.  If everyone has a “different path” and won’t compromise/discuss different paths to come up with a compromise… then the odds of good results, probably decreases dramatically.

The first thing that the pt needs to get a answer to… is what intensity of pain does the practitioner expects the pt to live/exist in.  IMO, a pt’s intensity of pain can basically put into two levels .. =<5 is probably a tolerable level of pain and >5 is an intolerable level of pain and is most likely requiring the pt to live/exist in a torturous level of pain.

If the practitioner can only answer that whatever level of pain the pt has to exist/live in …depends on the MMG/day that the CDC’s guidelines states is the max allowable dose for all disease issues. If this is the limit to the practitioner’s treatment plan and the pt is willing to live/exist in the intensity of pain level that xx MME/day will provide, all advocacy efforts are finished.  If this is the answer to the pt’s treatment, or the pt can share this article with the practitioner  https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154 and ask the practitioner why he/she is limiting pain management therapy based on the MME system which has no science nor double blind clinical study behind it.

Here is a chart that demonstrates the possible complication of pt’s comorbidity from under/untreated pain …

If the practitioner, suggests/insists that you get  non-opiate, non-covered health services (PT, massages, aqua therapy, etc ) not covered by your insurance.  here is free software that has included in its package a spread sheet.  Just create a spread sheets for your monthly income and your monthly expenses… don’t  have to detail, just each month’s total expenses.  Ask the practitioner who he/she would suggest that you work the cost of such health services into your budget.  https://www.openoffice.org/download/index.html   If you don’t drive, how are you suppose to get to the medical appt ?

If  your BP increases dramatically (>180/100), when your pain meds are reduced/stopped, and even after given up to four different BP meds.. suggest that the following graphic be shared with the practitioner, to get confirmation that the practitioner understands the risk – you as their pt – are being put into… high blood pressure – per American Heart Association has always referred to as the “silent killer”

So the practitioner just tells you to take a NSAID (Aspirin, Motrin, etc) to manage your pain.  Just find a number of studies on warning the potential consequences to a pt using NSAIDS long term- kidney damage the most common.

So the practitioner just tells you to take Acetaminophen (Tylenol) to manage your pain.  Just find a number of studies on warnings the potential consequences to a pt using Acetaminophen long term – liver damage the most common

If your practitioner basically “blow your concerns off”, I would created a cover letter and I would take copies of all the information that you provided the practitioner and send them back to the office or dept that manages pt medical records and ask that they all be put into your medical records.  It might not do you, individually, much good, but your family will be able to sue the practitioner if/when you suffer a stroke, heart attack, eye/kidney/liver damage, premature death or commit suicide…  You have put your practitioner on notice that you made them aware that you were aware of the physical health consequences you may suffer, because of their plan of treatment of you.

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Billion-Dollar Bounty for AARP

The American Association of Retired Persons (AARP) agreed to an exclusive promotional deal in September with Oak Street Health, which operates 100 primary care clinics in a dozen states, according to Kaiser Health News.

The deal allows Oak Street Health to use AARP in its marketing for an undisclosed fee, according to the report.

This arrangement falls in line with a lucrative practice by the AARP, where the organization collects “royalties” in exchange for exclusive marketing deals with healthcare businesses eager to promote themselves to AARP’s membership.

In total, the AARP collects $1 billion in these kinds of royalties, according to its 2020 financial statement, KHN reported. About two thirds, or $752 million, of those royalties come from “health products and services,” according to the article. For comparison, AARP collected roughly $300 million in member dues in 2020.

There are questions about whether these partnerships are chosen because they benefit AARP’s members or because they are so profitable for the organization, according to the report. Marilyn Moon, who is a health policy analyst with ties to AARP since the 1980s, told KHN that it “certainly is a problem,” when the organization is profiting from these medicare-focused marketing partnerships while also lobbying on Medicare issues in Washington, D.C.

The partnership with Oak Street Health highlighted those concerns when the company came under investigation by the U.S. Department of Justice for its marketing tactics, KHN reported.

“It’s hard to know whether they’re advocating for their business interests or for the seniors that they are supposed to represent,” Joshua Gordon, director of health policy for the Committee for a Responsible Federal Budget, a nonpartisan group, told KHN.

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Go-broke dates pushed back for Social Security, Medicare

https://www.foxbusiness.com/politics/go-broke-dates-pushed-back-social-security-medicare

The time frame for Social Security and Medicare to go-broke has been pushed back, helped by a stronger-than-expected economic recovery from the coronavirus pandemic.The annual Social Security and Medicare trustees report says the Social Security trust fund will be unable to pay full benefits beginning in 2035, instead of last year’s estimate of 2034. 

The projected depletion date for Medicare’s trust fund for inpatient hospital care moved back two years to 2028 from last year’s forecast of 2026.

According to the report, “Economic recovery from the 2020 recession has been stronger and faster than assumed in last year’s reports, with positive effects on the projected actuarial status of the trust funds in these reports.”

Forecasters said in the report that the ongoing COVID-19 pandemic will have no net effect on their long-range projections. 

The assumptions for the latest report were made in February, which was before cases began climbing again and inflation rose even higher.

President Biden said in a statement that the report “shows that the strong economic recovery driven by my economic and vaccination plans has strengthened programs that millions of Americans rely on and has put our nation in a better fiscal position.”

Social Security pays benefits to more than 65 million Americans, mainly retirees as well as disabled people and survivors of deceased workers. Medicare covers roughly 64 million older and disabled people.

A main source of financing for the programs is payroll taxes on earnings paid by employees and employers. About 183 million people paid those taxes in 2021.

Social Security retirees got a 5.9% boost in benefits this year, the biggest cost-of-living adjustment, also known as COLA, in 39 years.

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What some hospital healthcare employees are saying about GUN VIOLENCE

https://www.beckershospitalreview.com/hospital-management-administration/michael-dowling-every-single-us-hospital-leader-should-be-screaming-about-what-an-abomination-this-is.html

Americans and global leaders have responded to the May 24 shooting at a Texas elementary school with heartbreak, anger and calls for change to better fight gun violence. But if you’re paying attention, the calls out of healthcare — from trauma surgeons, pediatricians, nurses, leaders and more — carry a distinct type of exasperation and sorrow. 

“I’m in one of my hospitals now, sitting with some staff talking about it — it’s just so frustrating,” Michael Dowling, president and CEO of New Hyde Park, N.Y.-based Northwell Health, told me over the phone early Wednesday morning. “This does not represent what the United States stands for — that we allow people who should never be allowed to carry a gun to do so and walk into a school and kill fourth graders.”

The attack by a lone 18-year-old gunman at Robb Elementary School in the small town of Uvalde, Texas, has left at least 19 students and two adults dead. Students in the school, grades 2 through 4, were two days away from summer vacation. 

Unlike many other known threats to our health, seeing the medical community condemn mass shootings still seems to leave some Americans doing a double take. It’s increasingly difficult to see what has them confused. 

In 2016, the American Medical Association declared gun violence a public health crisis after a lone gunman killed 49 people and wounded 53 more in a mass shooting in a gay nightclub in Orlando, Fla. Even after the declaration, healthcare professionals and leaders continued to defy insistence from gun rights advocates that gun violence was not within their specialty or expertise. Or as the National Rifle Association put it in simpler terms in 2018: “Someone should tell self-important anti-gun doctors to stay in their lane.” The #ThisIsOurLane movement started then. The attempt to silence medical professionals ironically made their calls for action louder.

As healthcare professionals responded to the ongoing public health emergency of COVID-19, the arms race grew and gun buying intensified — “a surge in purchasing unlike anything we’ve ever seen,” as one gun researcher at the University of California, Davis, put it. People who already owned guns bought more, and people who had never owned a gun bought them too. In 2020, firearm-related injuries were the No. 1 cause of death of children and teens, according to the CDC. 

Every day, 321 people are shot in the United States, and more than 40,000 Americans die from gun violence each year. Yet some healthcare executives still fear that taking the position that gun violence is a public health crisis will throw them into political turmoil given how toxic politics are in this country. It’s one position for the AMA and its 250,000-plus members to take, but another for an individual leader who may be the face of an organization in their community. There are risks of offending board members, donors, elected officials and other constituents ⁠— including patients. But here’s the thing: There will always be a reason to delay, to soften language, to wonder if this mass shooting is the one to react to.

Mr. Dowling urges his colleagues to step it up, noting how hospital and health system leaders can be ambassadors for gun safety in their communities, given the influence they wield as the largest employers in many communities.

“This is about protecting people’s health. This is about protecting kids’ lives. Have some courage. Stand up and do something,” he said. “Put the interest of the community in the center of what you think about each and every day. Our job is to save lives and prevent people from illness and death. Gun violence is not an issue on the outside — it’s a central public health issue for us. Every single hospital leader in the United States should be standing up and screaming about what an abomination this is.

“If you were hesitant about getting involved the day before May 24, May 24 should have changed your perspective. It’s time.”

Northwell established The Gun Violence Prevention Learning Collaborative for Health Systems and Hospitals, a grassroots initiative that gives healthcare professionals the space to have open dialogue about the impact of gun violence, share best practices and collectively take action. Learn more here. 

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The GoodRx-Kroger Blowup: Spread Pricing, Pharmacy Margins, and the Future of Discount Cards

https://www.drugchannels.net/2022/05/the-goodrx-kroger-blowup-spread-pricing.html

A few weeks ago, GoodRx surprised investors with the unpleasant news that a major grocery chain had stopped accepting its discount card for an unspecified number of prescriptions. As I explain below, the unnamed chain appears to be Kroger—the sixth-largest U.S. pharmacy. What’s more, GoodRx disclosed that Kroger accounts for an unexpected one-quarter of its prescription business.

The GoodRx situation highlights crucial issues about the complex web of relationships and conflicts that support today’s discount card model. Below, I break down the economics of the discount card business to help frame the outlook for discount cards.

As I explain, discount cards are really just another form of spread pricing. As the market for patient-paid prescriptions has expanded, disputes about the appropriate split of these spreads will pressure pharmacy-PBM relationships and drive change in the discount card business model.

A well-known African proverb states: “When elephants fight, it’s the grass that suffers.” Will investors continue to support GoodRx—or move on to greener pastures? Read on and see what you think.

READ ME

Here are the relevant materials from GoodRx’s 2022:Q1 earnings announcement:

• GoodRx Q1 2022 Letter to Shareholders

• GoodRx Earnings Call transcript (5/9/22)

As always, I encourage you to review the original source material for yourself.

You may find it useful to review my previous articles about GoodRx and its business model:

• How GoodRx Profits from Our Broken Pharmacy Pricing System

• How GoodRx’s Rapid Growth Creates Conflict between PBMs and Payers

• Why GoodRx—Not Amazon—May Be the True PBM Disrupter

I place GoodRx within the broader context of patient-paid prescriptions in Section 4.3. of DCI’s 2022 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers.

TUSK TO TUSK

GoodRx described the unexpected financial surprise in its letter to shareholders:

“In addition, we recognized that a grocery chain had taken actions late in the first quarter of 2022 that impacted acceptance of discounted pricing for a subset of drugs from PBMs, who are our customers, and whose pricing we promote on our platform.”

On its earnings call, GoodRx disclosed that the chain accounted for less than 5% of the pharmacies in its retail network, but “almost one-quarter of its prescription transaction revenue.” That equates to about $38 million in GoodRx’s first quarter revenues, or about $150 million annually. The company projected that the financial impact would be roughly $30 million in the second quarter, but wouldn’t forecast beyond that point.

This was a startling disclosure. Like many other people, I was not aware that GoodRx had become so dependent on a single chain. Since the announcement, the company’s already depressed stock price has remained below $9. In early 2021, its stock price peaked at nearly $57. Ouch.

According to Wall Street analysts, the grocery chain that no longer accepts the GoodRx discount card for some or all prescriptions is Kroger. Multiple consumer posts on Twitter have confirmed this awkward reality. (For example, see here and here.)

We estimate that Kroger accounts for only 3% of total U.S prescription revenues. This suggests that GoodRx was dramatically over-indexed to a single chain.

As you can read in the earnings call transcript, GoodRx management tried valiantly to spin this situation. They correctly noted that the dispute is not between GoodRx and Kroger, but instead between Kroger and at least one of the PBMs that manages GoodRx’s retail discounts.

That’s why the GoodRx team made an analogy to the Walgreens/Express Scripts dispute from 2012. (They didn’t explicitly mention these two companies, but it’s clear from the context.) Travel back 10 years via the Drug Channels wayback machine for a refresher: Walgreens is Losing Its Battle with Express Scripts and Walgreen Cuts a Deal with Express Scripts.

I found GoodRx’s commentary to be confusing and hard to decipher. Here’s my take on what’s really going on.

DISCOUNT CARDS = SPREAD PRICING

Spread pricing is one way that third-party payers can compensate a PBM for plan administration and other services. With spread pricing, a payer compensates a PBM by permitting the PBM to retain differences, or spreads, between (a) the amount a PBM charges the payer, and (b) the amount the PBM pays the pharmacy that’s dispensing the prescription to a patient. We estimate that spread pricing has become much less important to large PBMs’ overall profitability. (See Section 11.2.3. of our 2022 pharmacy/PBM report.)

However, many people don’t appreciate that spread pricing is the primary way that PBMs profit from discount cards. Consequently, the Kroger/PBM dispute is really a fight over how this spread gets split.

The chart below illustrates the flow of products and money when a patient uses a discount card to pay the full cost of their generic drug prescription, without using third-party insurance. Since generic drug manufacturers don’t pay rebates to PBMs or payers, those flows have been eliminated from the chart.

There are some notable differences from the conventional scenario illustrated in our well-known follow-the-dollar chart:

Assuming that PBMs don’t lose money on discount card prescriptions, then total discount card spreads are (on average) greater than 15% of the total retail consumer cost.

Let’s assume that GoodRx keeps 75% of discount card spread, while PBMs keep the remaining 25%. Here are some rough estimates of the GoodRx/PBM/Kroger prescription economics:

• Total prescription revenue from consumers using GoodRx at Kroger pharmacies = $1 billion (= $150 million ÷ 15%)

• GoodRx transaction revenue from Kroger = $150 million

• PBM transaction revenue from GoodRx at Kroger = $50 million (assuming 25% of total discount card spread)

• Net Kroger prescription revenues = $800 million (= $1 billion minus $200 million discount card spread)

Wow. Good money, if you can get away with it.

TRAMPLED UNDER FOOT?

The figures above are becoming crucial in understanding the forces driving the future of discount cards. Here are three trends to watch:

1) Patient-paid prescriptions are growing.

Prescription costs are increasingly shifted to patients through deductibles and coinsurance. Consequently, a growing share of prescriptions have no third-party contribution, because patients pay the full cost out of pocket.

What’s more, generic prescription pricing is so broken that more than 70% of the consumers who used GoodRx already had commercial or Medicare insurance. GoodRx has even estimated that more than half of prescriptions filled using its discount card were cheaper than the average commercial insurance copays for the 100 most purchased medications.

We estimate that patient-paid prescription accounted for about 9% of unadjusted prescriptions in 2021. Discount cards were more than half of this patient-paid prescription activity.

[Click to Enlarge]

Patient-paid prescriptions that use a discount card are not considered cash-pay, because the claims are adjudicated by a PBM. Thus, they lead to a consumerization of retail prescriptions—but not necessarily of the pharmacy and PBM industries.

2) Pharmacies will push back against shrinking discount card margins.

3) PBMs will react to the danger from discount cards.

In my recent video webinar PBM Industry Update: Trends, Controversies, and Outlook, I explained how patient-paid prescriptions could disrupt the PBM business.

Let’s see if GoodRx will be savvy enough to avoid becoming trampled grass.

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PT called the clinic repeatedly complaining of pain and specifically targeted the doctor who performed the surgery

I heard it through the GRAPEVINE

A video diatribe attacking yours truly over something that I SHARED ?

A doctor’s murder over an opioid prescription leaves an Indiana city with no easy answers

It is unfortunate that a certain federal bureaucracy has allowed those with valid medical needs (chronic pain & mental health) to be divided and basically at odds over how each group is treated or MISTREATED and many healthcare providers are denying care to pts that would have probably got care while the Federal Law Decade of Pain Law (2000-2009) was active and on the books.   It is also pathetic that certain non profit groups have achieved some high visibility & credibility  because they have aligned themselves with the DEA’s agenda…  there is so many, I will not attempt to list them…. they know who they are and many within the chronic pain community know who they are.

So we basically have 4 different groups at odds  chronic pain pts, mental health/addiction pts, heatlhcare providers, and all those bureaucrats and non profits fighting the war on drugs/pts. It would seem like the last group or the suppressors and the first three are the victims.

The shooting of the two docs and office staff and pt recently WAS NOT A FIRST..  but the first that I am aware of was back in 2017 in Indiana, see link above.

The first video is from a pain doc calling a person out, who puts themself out as a “chronic pain advocate”…  I was recently told that this “chronic pain advocate” charges any pt who want them to advocate for them person to person … the upfront cost is $350 setup & $200/hr….  I don’t know if that is plus travel expense, room & board and related expenses or if “in person advocating” is a “virtual advocating”

The chronic pain community seems pretty “roused up” over what this “chronic pain advocate” posted on Tic Tok about the 4 murders and 1 suicide.

Will this incident cause the victims to come together and put up resistance to those that are suppressing hundred of millions of people with legit medical needs and the healthcare providers who would prefer to treat those people with valid medical necessities.

The chronic pain community needs to realize who is really behind and supporting them and who is attempting to monetize the chronic pain community in various ways.

I would not put any money on the various groups would come together, but THIS CRAP HAS GOT TO STOP.

FULL DISCLOSURE: I am the UNPAID consultant Pharmacist for the American Pain & Disability Foundation and I support what they are doing and what they have accomplished using only voluntary donations to the foundations.  Personally, I have never accepted the first dollar from a chronic pain pt for providing them advice on their particular issue/problem, and if anyone says otherwise…. IS A LIAR !!!

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This is such a shame, I just wonder if this surgeon told this pt prior to the surgery that the surgery would “resolve his back pain”.  Of course, no surgeon can “promise” that surgery will “correct the problem”.  Apparently the pt had reach out to the surgeon to get something to help him manage his pain.  It would seem that the surgeon ignored the pt’s repeated contacting the surgeon/office about pain management and this story would suggest that the pt’s requests had been ignored and/or the pt’s request for pain management was DENIED… this is not clear from this article.

Could this surgeon be just an employee of the Saint Francis Health System and just following the mandates of his corporate employer about how many days or how many doses a pt can be provided post surgery for pain management ? If so, could some exec, committee or BOD be responsible for implementing such “one size fit all” pain management policies… which could be the genesis of this tragedy. Even if any of this is true, guess who will get blamed for this tragedy ?

My money is on that if this pt had just went to the surgeon’s office and committed suicide in the waiting room of this office… NOTHING WOULD HAVE BEEN ON ANY MEDIA.

Tulsa shooting gunman targeted surgeon he blamed for pain, police say

https://www.cbsnews.com/live-updates/tulsa-shooting-press-conference-watch-live-stream-today-2022-06-02/

A man who blamed his surgeon for continuing pain after a recent back operation bought an AR-style rifle Wednesday and carried out a shooting that same day at a Tulsa, Oklahoma, medical office, killing the doctor and three other people in an attack that ended with him taking his own life, police said Thursday. The gunman called the clinic repeatedly complaining of pain and specifically targeted the doctor who performed the surgery, Tulsa Police Chief Wendell Franklin said.That physician, Dr. Preston Phillips, was killed, along with Dr. Stephanie Husen, receptionist Amanda Glenn and patient William Love, Franklin said. The attack occurred on the campus of Saint Francis Health System in Tulsa. The chief identified the shooter as Michael Louis, 45, of Muskogee, Oklahoma.

A letter found on the gunman “made it clear that he came in with the intent to kill Dr. Phillips and anyone who got in his way,” Franklin told reporters. “He blamed Dr. Phillips for the ongoing pain following the surgery.”

It was the latest in a series of mass shootings in the U.S. including the deadly school shooting in Uvalde, Texas, and an attack on a supermarket in Buffalo, New York. Over the weekend in Taft, Oklahoma, a woman was killed in a mass shooting during a Memorial Day event that also left seven people injured, police said.

Phillips was an orthopedic surgeon with an interest in spinal surgery and joint reconstruction, according to a profile on the clinic’s website. He once served as lead physician for Tulsa’s WNBA team before the franchise moved out of state, according to the Tulsa World.

Dr. Cliff Robertson, president and CEO of Saint Francis Health System, called Phillips a “consummate gentleman” and “a man that we should all strive to emulate.” He said the three employees who were killed were “the three best people in the entire world” and that they “didn’t deserve to die this way.”

Police believe the gunman bought his weapons legally, Franklin said. The gunman bought an AR-style semi-automatic rifle on the afternoon of the shooting and a handgun on Sunday, the police chief said.

Franklin praised the law enforcement officers, 911 operators and emergency responders for their “immediate response” to the attack. Police responded to the call about three minutes after dispatchers received the report at 4:52 p.m. and made contact with the gunman at 5:01 p.m., authorities said Wednesday.

“Our training led us to take immediate action without hesitation,” he said. “That’s exactly what officers do and that’s what they did in this instance.”

The length of time it took police officers in Uvalde to engage the gunman during last week’s deadly school shooting at Robb Elementary School has become a key focus of that investigation. Officers waited over an hour to breach the classroom where the 18-year-old gunman attacked with an AR-style semi-automatic rifle, killing 19 children and two teachers.

The spate of recent gun violence across the country has led to Democratic leaders amplifying their calls for greater restrictions on guns, while Republicans are emphasizing more security at schools. Bipartisan discussions are also being conducted.

The White House said President Biden will deliver a primetime address Thursday night to talk about gun violence.

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The PBM industry started in 1969-1970 and worked for many years under contracts with insurance companies.  At some point, all the major PBM’s became licensed insurance companies and were then protected from the Sherman Anti Trust act by the McCarran Ferguson Act, which exempted insurance companies from Sherman Anti trust.

Over the decades, many different states have tried to start having oversight over these PBM companies and each time. The PBM industry would bring out a “army” of lobbyists and attorneys to convince legislators that regulating the industry would cause med prices to rise and community pharmacies – in particular – would make “excessive profits”. In the end, the various legislatures believed them and the industry continued to function without any any oversight and whose financial arrangements were kept hidden.

In the last 5 yrs or so… these types of PBM overcharges are coming to light.  The PBM industry controls the price of upwards of 90% of all Rxs filled.  This one study is JUST IN ONE STATE (FL) and JUST WITH MEDICAID.

Just imagine, we fill some FOUR BILLION prescriptions every year and the PBM industry controls the pricing of upwards of 90% of those Rxs. All those excess profit that they have generated shows up in your insurance premiums and copays.

Pres Biden says that he wants to lower Rx med prices….  If he doesn’t start with the PBM industry, his efforts will be a ABSOLUTE FAILURE. Given that the insurance industry has one of the LARGEST BUCKETS OF MONEY FOR LOBBYING CONGRESS and now the top 4-5 PBM companies are owned by some major insurance company. I am not expecting much to change.

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