New York state plans major lawsuit against drug makers
Sep. 11, 2019 – 6:37 – Governor Andrew Cuomo accuses drug makers of causing ‘immeasurable’ damage; reaction on ‘The Five.’
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New York state plans major lawsuit against drug makers – Governor Andrew Cuomo accuses drug makers of causing ‘immeasurable’ damage; reaction on ‘The Five.’
Posted on September 11, 2019 by Pharmaciststeve
Neighborhood pharmacies, under siege
Posted on September 11, 2019 by Pharmaciststeve
Neighborhood pharmacies, under siege
I proudly represent hundreds of neighborhood-based pharmacists who stand at the front line of health care for families in their communities. Patients depend on their pharmacists for advice on medications, to ask general questions about their health and of course to get the medicine they need, when they need it.
Across New York State, neighborhood pharmacies play a big role in our economy. The National Community Pharmacists Association reported that the Empire State was home to some 2,400 community-based pharmacies in 2017. They generated approximately $8.4 billion in outlet-wide sales and employed more than 22,000 people that year.
But today, independent neighborhood pharmacies face a serious competitive threat. You may assume I’m referring to chain pharmacies, but I’m not. You might think chain drug stores pose challenges to us, but we’re happy to go head-to-head with them when it comes to the quality and intimacy of our services.
In fact, the primary threat to our survival comes from a cadre of greedy middlemen who occupy an obscure and exploitative stratum of the prescription drug supply chain. Called Pharmacy Benefit Managers, they’re a powerful force wreaking havoc on local drug stores.
The stealthy, all-but-extortionate impact of PBMs has surged in the past few years.
OK, so what do these PBMs actually do?
Originally designed to help insurers manage insurance claims paperwork and provide administrative support, PBMs have grown into an unwieldly, hydra-like beast. PBMs play the role of middlemen among insurers, drug makers and pharmacies, exercising control over which drugs your insurance will cover, drug prices and the reimbursement levels pharmacies receive when distributing medications. They can even dictate which drugs doctors can prescribe for you.
And they’ve consolidated. Today, the vast majority of prescriptions are processed by PBMs that own or are owned by major national health insurance companies – Cigna, United HealthCare and Aetna – and these three PBMs, all Fortune 25 corporations, collectively control nearly 80% of the market.
Not only can PBMs determine what drugs a patient uses; they can also determine where a patient gets their drugs. PBMs will frequently self-refer patients to mail order or chain pharmacies that are in their network, resulting in a greater return for the PBM even though this may not be the most affordable option for the patient.
Last January, a survey of more than 500 New York City neighborhood pharmacy owners conducted by the New York City Pharmacists Society showed how deeply PBM abuses are jeopardizing the viability of “mom-and-pop” pharmacies. Seventy percent of the owners were forced to reduce store hours or lay off employees last year because of PBM abuses. Ninety-two percent have contemplated similar curtailments this year for the same reason.
One nefarious PBM practice is called “spread pricing,” which usually pertains to the pricing of generic drugs. Under spread pricing, PBMs charge their sponsor-client one price for a drug, then most often pay the dispensing pharmacy a much lesser amount (frequently below the pharmacy’s cost), pocketing the difference for themselves.
This is contributing to the closure of family pharmacies. And it cost the state’s Medicaid managed care organizations at least $300 million in overcharges in 2018, according to the Pharmacists Society of the State of New York.
PBMs often force neighborhood pharmacies to sign onerous, take-it-or-leave-it contracts that dictate reimbursement rates. As small mom-and-pop businesses, we’re in no position to go up against some of the country’s largest corporations.
A recent state Senate report found that PBMs often demand patients to fill prescriptions using PBM-owned mail order pharmacies, further impairing the viability of local pharmacies.
Fortunately, lawmakers are now recognizing the damage caused by PBM misconduct and are starting to reel in their power. For example, while “spread pricing” continues in the private sector, Albany recently banned its use in the state’s Medicaid program. And, taking a cue from several other states, both houses of the state Legislature recently passed a PBM reform package that will help protect patients, taxpayers and neighborhood pharmacists from our broken prescription drug system.
The bill would mandate the licensing and regulation of PBMs, require disclosure of the details of “spread pricing” in both private and public insurance plans, and require disclosure of information on discounts, rebates and other kick-backs they receive from drug manufacturers — and make sure those savings are passed on to consumers.
Now, it’s up to Gov. Cuomo to sign this bill. The time has come to neuter the deleterious impact of this industry.
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Chronic Pain Suicide: as seen on the web 09/11/2019
Posted on September 11, 2019 by Pharmaciststeve
My close friends brother-in-law committed suicide last Sunday, he wasn’t found until tuesday. He suffered chronic pain, would run out of his meds early and use alcohol in between time. He isolated himself.
This last refill, he took them all and left a 3 page letter. His name is Mark Apple. He leaves behind 2 brothers (one is a twin) and his mother. He was unmarried and had no children.
This is so sad. I hate this so much. There is just no reason this should happen, that people lose hope simply because they can’t get relief.
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“Narcan is as useful for me as a screen door on a submarine”
Posted on September 11, 2019 by Pharmaciststeve
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DEA proposes lowering opioid production quotas by 30% , expanding marijuana research
Posted on September 11, 2019 by Pharmaciststeve
DEA proposes lowering opioid production quotas, expanding marijuana research
https://www.washingtontimes.com/news/2019/sep/11/dea-proposes-lowering-opioid-production-quotas-exp/
The Drug Enforcement Administration on Thursday proposed reducing the manufacturing quotas for the five most frequently abused opioids by an average of 30 percent in 2020.
Simultaneously, the DEA announced it would triple the amount of marijuana grown for research.
The moves signal the Trump administration is cracking down on opioid abuse while softening its hard-line stance on marijuana as a number of states continue to legalize its use.
“DEA takes seriously its obligations to both protect the public from illicit drug trafficking and ensure adequate supplies to meet the legitimate needs of patients and researchers for these substances,” DEA acting Administrator Uttam Dhillon said in a statement.
The anti-drug agency said will reduce fentanyl production by 31 percent, hydrocodone by 19 percent, hydromorphone by 25 percent, oxycodone by nine percent and oxymorphone by 55 percent.
Combined with a reduction in morphine, the proposed quota would decrease opioid production by an average of 53 percent since 2016.
The DEA is requesting more than 3.2 million grams of marijuana to be grown legally in 2020, up nearly a third from the 2.4 million grown this year. The increased haul will be used for scientific research.
Both proposals are part of the DEA’s annual quota for manufacturing controlled substances to meet the nation’s medical, scientific, research and industrial needs.
800,000 GMS increase in MJ for RESEARCH… that is abt 1750 lbs.. or about 5 lbs/day.
Cut the availability of opiates for legal therapy, and increase MJ for RESEARCH… meaning that it could take 10-15 yrs before that research could get a meaningful MJ product for treating various health issues… NO GUARANTEES that anything will prove to be useful for treating any health issue.
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Human Rights Watch Accuses Tennessee Of Over-Regulating Pain Management
Posted on September 10, 2019 by Pharmaciststeve
Human Rights Watch Accuses Tennessee Of Over-Regulating Pain Management
A report from Human Rights Watch accuses Tennessee of regulating opioids to the point of depriving patients in pain. Along with Washington State, the analysis focuses on Tennessee because of its new prescribing regulations, which are considered some of the strictest in the nation.
In its 109-page report, Human Rights Watch interviewed patients who were involuntarily weaned off of high-doses of powerful painkillers. Tennessee’s new law doesn’t directly impact so-called chronic pain patients, but it seems to have had a chilling effect. Several tell the advocacy organization that their doctors feel pressure to lower everyone’s dosages.
Gail Gray of Celina, Tennessee, tells HRW that her primary care physician cut her pain medication nearly in half but still felt like he could get in trouble. So Gray was forced to a clinic an hour away, which she worries might be a “pill mill” since they only take cash.
“I’m not comfortable with this. I feel like he [my primary care doctor] has pushed me into doing something that’s not right, and I don’t want to break the law,” she said.
More: Tennessee Doctors In Training Mode As Nation’s Tightest Opioid Restrictions Take Effect
HRW also interviewed clinicians, like a nurse practitioner from Vanderbilt’s hematology department who tells of her difficulty with insurance companies denying heavy prescriptions for a sickle cell patient.
A doctor in Knoxville describes how a new state law requiring physicians to try alternatives before turning to opioids has resulted in risky decisions. At times, he’s recommended surgery as a first course of action, just to avoid flack from regulators.
“It’s really against everything I was trained to do, but it’s the will of the legislators and regulators,” Dr. Joe Browder said.
The state did not respond to the study, which was funded by the U.S. Cancer Pain Relief Committee, a nonprofit with ties to pain management and the pharmaceutical industry. But Human Rights Watch says its top recommendation is for states to just limit the unintended consequences of cracking down on opioid prescribing.
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Calling all CPP group leaders and CPP advocates
Posted on September 10, 2019 by Pharmaciststeve
Calling all CPP group leaders and CPP advocates:
We are developing a questionnaire to send out to House, Senate, and Presidential Candidates to find out their positions on areas of our concern. By doing so, we also tell them those areas of concern, and hopefully get them to be vocal about them on the campaign trail. It’s time that the topic of the war on doctors and patients no longer be ignored by the political parties and their candidates.
We are developing a questionnaire to send out to House, Senate, and Presidential Candidates to find out their positions on areas of our concern. By doing so, we also tell them those areas of concern, and hopefully get them to be vocal about them on the campaign trail. It’s time that the topic of the war on doctors and patients no longer be ignored by the political parties and their candidates.
This is a major undertaking, with hopefully 1000+ replies. We will need to have a data-evaluation service or some manner of organizing and reviewing the replies.
Are you willing to help? If so, reply on the Contact form on https://doctorsofcourage.org/communication-campaign/.
Right now, please give us questions you think are pertinent to be answered by the candidates. Tell us if you are willing to work on a panel to construct the questionnaire. If you know of anything like this that has been done before, please share. And last, but definitely not least, tell us if you have access to a data-evaluation program, or could get your hands on one. This is way over my level of IT capability. But computer data-crunching would be so much more time-effective than the old-fashioned way.
This is something that we can all do together with the greatest impact to make a difference in the War Against Doctors and Patients. I hope that all leaders get involved in one way or another. Please re-post to your own group as well, to spread the word. Share by email to all advocacy groups.
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The Washington Post is interested in speaking with pharmacists and pharmacy technicians
Posted on September 10, 2019 by Pharmaciststeve
The Washington Post is interested in speaking with pharmacists and pharmacy technicians who worked at chain drug stores during the opioid crisis between 2006 and 2014. If you want to talk to one of the reporters, reach out to Meryl Kornfield. Her cell is 305-798-6033 and her email is meryl.kornfield@washpost.com.
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Medical Board Corruption is violating Your Constitutional Rights!
Posted on September 10, 2019 by Pharmaciststeve
Medical Board Corruption is violating Your Constitutional Rights!
Feldman v Federation
Patient Petition
For Patients and their families, friends and loved ones
We, the undersigned, submit this petition in support of the above lawsuit, filed by Drs. Feldman and Kaul. We are the patients, the people without whom the American healthcare system would not exist, and the people for whom the system was intended to serve. We all suffer from chronic debilitating pain, that has had devastating and tragic consequences on our lives, and those of our fathers, mothers, brothers, sisters and children. We, the voting public, the people of this country, have been forgotten by the politicians, the insurances companies and healthcare corporations, who have raped our healthcare system for profit, mercilessly and behind their faceless corporations, have, through their predatory pricing deprived us of life saving care. We are dying and no one cares, except our doctors, healers like Drs. Feldman and Kaul.
Within at least the last five years, our access to life saving treatment has been either severely reduced or completely eliminated. This is a direct consequence of rampant corruption within state medical boards and reckless, evidentially unsupported policies propagated by politically motivated state and federal bureaucrats. These agencies and the people who work within them do not care for our welfare, our lives and the unrelenting pain in which we now live, because of their own selfish economic and political agendas. We wake in pain, we live in pain, and when we can actually go to sleep, we know that our relief will be short lived. Many of us think about suicide every day. At least in death we will have relief from the excruciating agony that now plagues our existence, because corrupt medical boards have taken away the licenses of our doctors, and deprived us of care. For some of us, our doctors have been sent to jail for life, for simply doing their job, that of healing our pain. We are shocked, saddened and find it hard to believe we live in America, the supposed land of the free and the brave. Well those brave enough to treat our complicated and debilitating pain have been mercilessly thrown into concrete cages, had their careers destroyed and left to rot, while we, and there are now many of us, have been abandoned by the profiteers and opportunists who now run our healthcare system. At the center of this cesspool of corruption are the state medical boards, who claim to “protect the public”. This is a massive lie.
These agencies abuse their power, unregulated, unsupervised and existing not to help the public, but to exploit and profit from the public, us. They use us as their excuse, their cover, to perpetrate their crimes against humanity. Their crimes contribute to the epidemic of physician suicides in the United States, reported as four hundred a year, although the number is likely much higher, and they kill patients, by taking away our doctors, jailing our doctors and causing them to commit suicide. Corrupt medical boards have permitted corrupt insurance companies, pharmaceutical companies and healthcare corporations to financially rape the American public, dictate local healthcare policy, and revoke the licenses of our doctors in the most cruel and arbitrary manner, with no regard for due process or the law. All of these events have caused us and our families immense suffering, and for too long we have suffered in silence, hoping that eventually sense would prevail, that our doctors would start to take care of us once again, without fear of jail or license revocation. We now see that hope in the lawsuit that Drs. Feldman and Kaul are about to file. We see two dedicated, courageous and committed men, whose fight is a righteous one, one for the people, for us, the American people, the people who pay taxes, who vote and who power, we are convinced, will cause Drs. Feldman and Kaul to prevail in their landmark case to end medical board corruption.
We will be victorious in our fight for justice.
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You may have noticed that I have not been around as much
Posted on September 8, 2019 by Pharmaciststeve
We have been at our Panama City Beach condo since Aug 2nd… Hurricane Michael took the metal roof off of our complex … some say that it was Michael’s Cat-5 status others have stated that it was a tornado that did the damage. We have a top floor unit and our ceiling is a concrete slab… so water ran down the conduit runs and penetrations in that slab. The picture below is a satellite of our complex post Michael’s landfall Oct 10,2018 and the part of the roof missing – center left – is over out unit. It is amazing how much damage a couple inches of water can cause.. it is also amazing how much damage that workman can do in the process of doing the repair work that they are in charge of doing…
The adjuster that the Association’s insurance company hired… – IMO – drug the Association’s Board of Directors around BY THE NOSE… I am not going to mention any companies that were involved – not yet anyway… once everything is finalized… there will be another post… naming names..
The company hired as the primary remediation … brought in a moving company from 1000 miles away – from Michigan that was suppose to room center and wrap our furniture. Apparently the first company PROMISED the moving company a certain amount of $$ to be generated and when the legit business didn’t generate that amount they arbitrarily “pack out” units that it was determined that too much contents and too much dry wall damage… and we got chosen to be such a unit… and it was done without us signing a contract with the first company and they were the one who made the decision as to what unit were packed out… I came down Dec 13th to find out unit COMPLETELY PACKED OUT… every piece of silverware, all dished, glasses & cups, the can goods in the pantry… they only thing left in the unit was a night stand and a dog bed…. and then we got a $25,000 moving bill…
And they forced us to have our belonging moved back in Memorial Day week – before all the interior work had been done… they returned all of our “excessive belonging” and 170 boxes that they packed everything else in…
Luckily Florida has a “price gouging law” that goes into effect during a declared emergency and I have filed a complaint with the FL AG’s office and they are going after this company seriously and I may get a largest – or all – of our money back for the moving expenses.
Our insurance company decided that since we did not have “wind insurance” – we have 150 MPH doors covered by 120 MPH metal hurricane shutters and nothing of any mass will get up this high… but our insurance denied any/all coverage – could have been as much as $120,000 because the water that got into our unit was INDIRECTLY WIND DRIVEN…
The people that did the drywall… only broke the kitchen sink faucet, broken half of our elec hurricane shutters and disconnected all of the R6 TV cables with WIRE CUTTERS..
I was able to hook up our TIVO system with the cable that comes into the unit and we have been able to STREAM shows from the TIVO and watched “TV” on our IPADS…
Because we didn’t know what monies that was going to come from the Association’s insurance… we built our own house 45 yrs ago… so the two of us have many VERY RUSTY skill sets … which we decided to start using… come to find out.. it is much like riding a bicycle… you never really forget the skill set.
BTW, the moving company brought back a RODENT INFESTATION back to the complex and the little varmints chewed the lines in the dish washer… causing it to leak… looking at our dishwasher.. it was manufactured in 1998 ..but since we only stay here 2-3 months out of the year… so it was 20 yrs old… and decided to replace it…
I have not been posting much… and not been very prompt in responding to emails… and hope that everyone understands… we have been seriously preoccupied with all of the repair work on our condo. If I had the time… I could write a book … on how condo complexes and owners being on the Board of Directors – with limited experiences in a lot of areas – are “running the show “… and not doing a very good job… But being only a single owner in a 134 unit complex… you have to go along with the crowd… and in our complex… the majority of the ownership … are more focused on what is good for their pocketbook and not what is good for the complex and the ownership as the whole.
About 100 units are rented by their owners, and since we are current been “closed” since Oct 10, 2018 and best estimate is that we will be back in the rental business Jan 1 , 2020… collectively the ownership has failed to generate AT LEAST 1.5 million in rental revenue… plus the cost of bringing their unit back to rental standards and not to mention the assessment – ours was $4700 – which may be the first of many.
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