Independent pharmacists sound the alarm on Surescripts, GoodRx partnership

https://www.mobihealthnews.com/news/independent-pharmacists-sound-alarm-surescripts-goodrx-partnership

Some pharmacists are pushing back on Surescripts’ partnership with GoodRx, arguing the deal will hurt independent pharmacies and further obscure the high cost of drugs.

“The deal was touted as a move towards transparency; when in fact, coupon programs are bought and paid for by the same PBM [pharmacy benefit manager]-based, opaque pricing schema the deal claims to upend,” wrote a group of pharmacists and pharmacy owners in a letter to Surescripts’ board obtained by MedCity News.

The partnership between the health data giant and GoodRx, announced earlier this month, would integrate GoodRx’s discount information into Surescripts’ platform that allows prescribing physicians to see the drug’s cost for their patients. GoodRx’s negotiated discounts would only appear for the uninsured or patients whose price information isn’t already available from their PBM or insurer, the companies said.

“We are always looking for ways to increase prescription price transparency and affordability for more Americans, so we are excited to work with Surescripts to arm prescribers with the tools and information they need to choose medications that are both accessible and clinically appropriate,” Doug Hirsch, co-CEO and co-founder of GoodRx, said in a statement when the deal was announced.

In their letter, the pharmacists said GoodRx only displays prices for their pharmacy partners, which would leave out independent pharmacies. The pharmacists also argued the drug coupon app’s business model works within a system that obscures the high cost of drugs.

“If coupons did not exist, we would motivate further innovation around pricing and pricing reform,” they wrote. “In a coupon-free world, market forces would drive the pharmacy charging $268 for rosuvastatin (which costs $0.03/pill) down to a reasonable amount or suffer extinction.”

WHY IT MATTERS

Drug costs have become a huge policy issue in the U.S. Between 2019 and 2020, retail prices for 260 widely used brand name prescription drugs rose by 2.9%, more than two times faster than inflation, according to a report by the AARP.

A Kaiser Family Foundation analysis published in July found nearly 3 million Medicare Part D enrollees had out-of-pocket drug spending above the catastrophic level between 2015 and 2019.

Earlier this month, the White House called on Congress to reduce drug costs for Medicare beneficiaries by allowing Medicare to negotiate with drugmakers, limiting price increases to inflation and capping beneficiaries’ yearly out-of-pocket spending to around $3,000.

“And by the way, it isn’t just seniors who will benefit. This would lower prescription drug prices for all Americans,” said President Joe Biden in a press briefing. “And here’s how: If Medicare prices are available to private insurance companies, then it would reduce the cost of employer-based health insurance coverage.”

THE LARGER TREND

GoodRx, founded in 2011, filed documents to go public about a year ago. 

In March, GoodRx announced its first full-year earnings since becoming a publicly traded company. It brought in $550.7 million in revenue in 2020, a 42% increase from the year before. The company did lose $298.3 million in GAAP net income in Q4 alone and $293.6 million for FY2020, which GoodRx attributed to expenses related to its IPO.

For this year’s Q1, GoodRx reported first-quarter revenue growth of 20% year-over-year to $160.4 million, only slightly missing expectations. 

The company has also been picking up acquisitions, including prescription price transparency company RxSaver in May and health education video producer HealthiNation in April.

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I am so sorry for the nearly 200 people that were killed by the Taliban and/or Isis-K  (including 13 of our military – the majority being in their early 20’s) in the middle east and the first military deaths in 15 months for our military in that area.  It had been wall to wall media coverage for the last 48 hrs and unknown how many hours going forward.

It is claimed that nearly TWICE AS MANY veterans commit suicide EVERY DAY and I have read where that number was derived from just 25 states data – so it could actually be twice as high.  At least 8600 veterans it is claimed to have commit suicide every year. That is about FOUR TIMES the total number of military deaths in the TWENTY YEARS that we were at war in Afghanistan.

We don’t know how many chronic pain pts have committed suicide and/or died prematurely because of having their pain meds reduced/eliminated and the complications of their comorbidity health issues very underlying causes of their premature deaths.

I guess what we – as a country – get these young people to volunteer to service in our military and we use/abuse them in defending our freedom and once their bodies are bent/broken… we provide, at best, poor medical care to these veterans, leaving them to themselves to deal with their chronic pain, PTSD and other chronic health issues to pretty much deal with on their own.

We are at – and have been at the war on drugs for 50+ yrs… I guess all wars have causalities.  Many of the causalities, in the war on drug, seems to be very INTENTIONAL.

Should the DOJ/DEA, CDC and VA healthcare system be considered/declared as TERRORISTS ?

What about Sen Marchin, that have been trying to put a opiate tax on opiate Rxs since 2016 https://www.pharmaciststeve.com/clinton-backs-manchin-plan-to-tax-opioids/

and again this year, Manchin and 11 other Senators are at the tax opiate Rx “well”  https://www.pharmaciststeve.com/the-opioids-crisis-dont-tax-pain-patients-to-treat-opioid-addiction/

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Find food assistance, help paying bills, and other free or reduced cost programs, including new programs for the COVID-19 pandemic

https://www.findhelp.org/

https://www.needhelppayingbills.com/

https://grantsforseniors.org/

https://www.rxassist.org/

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CALL TO ACTION: OKlahoma Independent pharmacists!!! (If I tagged you please share with your network of pharmacists!) I heard a great quote from Greg Reybold, “Everyone wants to fight until it is time to fight.” Well…. OKlahoma independent pharmacists now is as good of a time as any to get in this fight. PBMs are winning the fight in OKlahoma, and we need your help to turn the tide. We need your help

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CVS workshop tells employees to hold each other ‘accountable’ for ‘non-inclusive’ acts

https://www.foxbusiness.com/politics/cvs-inclusion-training-critical-race-theory

FIRST ON FOX: CVS Health is holding a “conscious inclusion workshop” that aims to teach employees how to hold each other “accountable” for non-inclusive behaviors, FOX Business has learned.

An internal email obtained by FOX Business showed David Casey, SVP of Workforce Strategies and Chief Diversity Officer, discussing the four-week program. The first three weeks included 20-30 minutes of self-study per week, leading up to a two-hour virtual workshop in the fourth.

In the email, Casey continues by outlining different “skills” employees will build during the workshop’s fourth week. Those included: “Identify unconscious bias in your day-to-day interactions and experiences,” “[d]emonstrate bravery by speaking up and having difficult conversations when observing non-inclusive behaviors,” and “[c]ommit to holding yourself and your colleagues accountable to consistently embrace diversity of all kinds, and take swift action against non-inclusive behaviors.” 

Joseph Goode, who serves as CVS’ senior director for corporate communications, told FOX Business on Tuesday the “workshop was announced in July 2020 as part of our nearly $600 million commitment to address racial inequality.” He added that “our stated goal is 100 percent employee participation.”

It’s unclear how employees would be held accountable and CVS did not comment when asked about this. However, the language seemed to touch on concerns about institutions pressuring people to adopt or advocate certain beliefs.

A CVS Health employee, who spoke on the condition of anonymity, told FOX Business they took offense at the implications behind the training.

“I was brought up to judge people in their actions, not their skin color or anything else,” the employee said. “I’ve tried hard not to throw people into categories and then treat them as the worst in said category. Just as someone unfairly judged should be incensed about that judgement, I’m mad about the assumption being made that I judge people just based on looks or where they’re from, and that I need fixing.”

Chris Rufo, who is currently rolling out a series of reports about trainings at major corporations, told FOX Business on Tuesday that CVS’ program was based on “pseudoscientific nonsense.”

“And what does CVS mean by ‘swift action against non-inclusive behaviors’?” he asked. “Will they suddenly tolerate the expression of conservative, traditional, or religious beliefs in the workplace? Of course not. Corporate inclusion is a farce, inspired by ideologues and implemented by morons. CVS is simply another company who has bought the snakeoil of ‘DEI.’”
President and CEO Larry Merlow said last year his company’s $600 million investment would “harness the strength of that diversity and focus on the areas where we can have the greatest impact.”

Besides corporationwide trainings, the company intended to “expand [m]entoring, sponsorship, development and advancement of diverse employees.” The company’s press release highlighted other initiatives as well, such as building on its “supplier diversity” program. According to its website, that program focuses on “partner[ing] with our business units to integrate supplier diversity into procurement activities, and with national organizations to identify and develop diverse businesses.”

Last year’s investment was a part of the company’s overall inclusion efforts. CVS’ 2020 Corporate Social Responsibility Report claims that “senior leaders” completed “conscious inclusion training” late in the year. In early 2021, the training was introduced to vice presidents and colleagues and the company began rolling it out to other employees in June.

The report reads: “Developed in collaboration with leading third-party experts, the program explores the science of bias and where and how it shows up in our business, and it facilitates the development of personal action plans for inclusion.”

Under “communicating gender identity,” the corporation said it started optional inclusion of pronouns on email signatures and business cards. The report added that it used a field research study to “gather more feedback from colleagues and customers on the use of pronouns on colleague name badges” in retail pharmacies. 

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CVS Lost More Controlled Substance Doses Last Year Than All Other Mass. Pharmacies Combined

https://www.wgbh.org/news/local-news/2021/08/24/cvs-lost-more-controlled-substance-doses-last-year-than-all-other-mass-pharmacies-combined

Nearly 7,000 doses of controlled substances went missing last year from CVS stores in Massachusetts — almost 70% of all drug doses lost by Massachusetts pharmacies last year, according to records obtained from the Massachusetts Board of Registration in Pharmacy.

CVS is the largest pharmacy chain in the state; Walgreens, its next largest competitor, lost about 1,300 doses from its pharmacies last year. In all, more than 10,000 doses of controlled substances went missing from all Massachusetts pharmacies in 2020.

The missing controlled substances from the CVS stores include oxycodone (brand name: OxyContin), amphetamine (Adderall), methylphenidate (Ritalin), morphine (Roxanol), methadone (Dolophine) and fentanyl (Abstral), all of which are extremely addictive. The missing controlled substances from the Walgreens stores include most of the same drugs.

“Anything more than zero is too much,” said Dr. Manuel Pacheco, a psychiatrist specializing in addiction psychiatry at Tufts Medical Center in Boston.

The lost — or stolen — pills can be extremely lucrative. The street prices of these drugs are significantly higher than what they go for in a pharmacy. One fentanyl patch, for example, purchased from the local pharmacy will cost $9.40; from a local drug pusher it’s $40. OxyContin dispensed at a pharmacy runs $6.50 a tablet; on the street, $15 apiece.

But Pacheco said lost pills are not the primary way people illegally obtain medications.

Pharmacies are required to adhere to rigorous procedures for keeping track of controlled substances, such as maintaining a perpetual inventory of the most addictive controlled substances, which include oxycodone and morphine. Yet the disciplinary reports from the pharmacy board reveal that in most cases CVS and Walgreens had no idea how the drugs vanished from their shelves.

A CVS spokesman said the loss of 7,000 doses of controlled substances at CVS stores is not a major problem.

“We have stringent policies and procedures in place to help prevent the loss of controlled substances, as well as to help detect it when it occurs,” CVS spokesman Michael DeAngelis said. “Drug diversion is typically discovered through our own internal processes and investigations. … We operate well over 400 pharmacies in Massachusetts.” Compared to other pharmacies, he said, “the number of controlled substance loss incidents we had last year was extremely low.”

CVS lost an average of 16 pills for each of its 420 stores in Massachusetts, while Walgreens lost an average of about 5 for each of its 245 stores. DeAngelis did not respond to follow-up inquiries about the disparity.

A Walgreens company spokesman declined to comment.

When Todd Brown, vice chairman of the Department of Pharmacy and Health Systems Sciences at the Northeastern University School of Pharmacy, was told of the large amount of missing controlled substances at a Massachusetts chain pharmacy, he said. “I know who it is — it’s CVS.”

“Historically, CVS has had a problem with missing controlled substances for some time now,” Brown said. “I don’t know why they can’t figure out a way to rectify everything. It’s not that complicated. The fact that you’re seeing one company continually having these issues means that they’re not exercising proper control. They’re simply treating the losses as a cost of doing business.”

CVS stores have been cited by the state pharmacy board for many years for the loss of controlled substances — ranging from five times in 2017 to 19 times in 2020. And Massachusetts is not the only place where CVS has had problems losing controlled substances. In New York, for example, CVS had to pay the federal government $1.5 million in 2018 after an investigation determined that the company failed to report the loss of controlled substances. In California, CVS shelled out $5 million in 2017 to the feds for various violations, including the loss of controlled substances.

John Burke, the president of Pharmaceutical Diversion Education in Ohio, said that the pharmacy board needs to get tough with pharmacies where controlled substances are disappearing.

“They need to clamp down hard by ramping up the penalties,” he said. “If I were running the board, I would call in the most senior pharmacy executive in the company and say, ‘Listen, here’s what you’ve done and not done. You’ve got to change this or there’s going to be drastic measures taken, even going so far as suspending the privilege of dispensing drugs.’”

Northeastern’s Brown also said that CVS is chronically understaffed, which often contributes to the loss of controlled substances. “Understaffing allows individuals to divert medications more easily because the rest of the staff in the pharmacy is busy trying to get everything done,” he said.

The pharmacy board has a wide range of punitive options available that it can impose on pharmacies and pharmacy personnel who commit controlled substance violations, including reprimands, censures, suspensions, revocations, probations, advisory letters and fines.

Of the board’s 70 total disciplinary and related actions against pharmacies, pharmacists and pharmacy technicians in 2020, more than half involved CVS and Walgreens, including

• Nineteen CVS and 15 Walgreens stores that were issued reprimands, put on probation, or given stayed probation;
• One CVS pharmacist who voluntarily surrendered his license;
• Four CVS and three Walgreens pharmacy technicians whose licenses were revoked or voluntarily surrendered.

The executive director of the state pharmacy board, David Sencabaugh, refused multiple requests for an interview through a spokeswoman.

Some CVS and Walgreens stores were repeat offenders. CVS stores located in Natick and Northampton, for example, were both cited twice last year for the loss of controlled substances, as were the Walgreens stores in Attleboro and Beverly.

Not all pharmacy chains have the same degree of losses in the state. Stop & Shop, which has 83 pharmacies in Massachusetts, lost 550 units of controlled substances in 2020, while Rite Aid, with 10 stores here, lost 61 doses. The 48 Walmart stores in Massachusetts did not lose any controlled substances.

Of the 240 independent pharmacies in Massachusetts, two — Apothecare in Brockton and Preferred Pharmacy Solutions in Haverhill — were cited by the pharmacy board for controlled substances violations.

Burke, the expert on drug diversion, says it may be time to get tough not just with the pharmacies where the controlled substances go missing, but with the board itself. “Maybe the pharmacy board members themselves don’t take the losses seriously enough,” he said. “If that’s the case, then you need to find the right people who will take it seriously.”

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