PBM abuse: to adequate pt access to their meds- cost of their meds – all to put $$$ to their bottom line

Loretta Boesing has a little child that has had a transplant and was forced to use a PBM mail order pharmacy to get anti-rejection medication from her PBM mail order pharmacy.  These medication(s) have a very specific temperature storage requirement – in order to maintain their potency. After her child started rejecting his/her transplanted organ — because the PBM mail order did not properly package these meds to maintain the required storage temp and thus the med did not maintain its proper potency.

This one single incident with Loretta’s child apparently brought out Loretta’s “MAMA BEAR INSTINCTS” and she has been on a crusade about mail order  pharmacies in particular and their blatant disregard to maintaining FDA required storage temp when mailing medications to pts.

There is FIVE MAJOR PBM’S – all owned by insurance companies – and each having their own mail order pharmacy andcollectively controlling some 80%-90% of the reimbursement for all Rxs.  Most all use some sort of financial disincentives to get their beneficiaries to use their mail order pharmacy or a particular chain pharmacy.  Anything from higher deductibles & co-pays, no coverage, if not filled in their preferred pharmacy.

One company in particular is expanding via what is called vertical integration – CVS Health, who owns Aetna Insurance, PBM Caremark, Medicare Part D (Silver Scripts), specialty pharmacies, mail order pharmacies, Omnicare Nursing home pharmacies, Minute Clinics – in store “doc in a box” and other such expansions that it is hard to keep up with the “medical tentacles” this “medical octopus” is adding to its array of medical services provided. 

Loretta has created an extensive assortment of videos of those involved with or adversely affected by the PBM industry.  I was starting to try and share some of Loretta’s video but she has so many and she is constantly adding to them.  I decided that I would just put the link below to her library of TicTok videos.

Below is a graphic that outlines into whose pockets the $$$ that the pt pays at the Rx register really goes.  The PBM industry started the year I graduated from pharmacy school and first licensed.  I have had a front row seat for the past 50+ yrs, to their financial shenanigans.

This particular video https://www.tiktok.com/@lorettaboesing/video/7209117283954740522?q=lorettaboesing&t=1678548023753 shows the arrogance of the PBM industry as a whole.  Pay attention to President Biden when he talks about lowering prescriptions prices,  the insurance/PBM industry is never mentioned as a source of reducing Rx pricing.  Maybe because as a former Senator, Biden understands the “army” of lobbyists and attorneys that the insurance/PBM industry could cause to descend on Congress when they were for/against something. Biden was first a Senator in 1973, I am sure that he is well aware of their abilities and why he doesn’t mention them as part of lowering Rx prices


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