Insurance companies are telling pharmacies if we have a product (regardless of expiration date) in stock for more than 30 days (which is extremely common) they can audit us and take back every dollar we submit for a prescription claim… The drug bottles we buy from wholesalers most commonly COME in 100 to 500 count bottle sizes. If I have ONE patient on a drug getting 30 pills a month, the 100 count bottle is considered a 3.3 month supply. Meaning the pharmacy can buy the drug with an expiration date of year 3000 (irrelevant) and JUST because the stock bottle has to sit on the shelf until the patient comes back next month means we lose 100% of the funds paid by the insurance company… lol I MEAN DO WHAT!? this is unbelievable. These insurance companies are owned by the big chain pharmacies.. who are our direct competitors… how is this NOT a monopoly, an abuse of power and criminal? This is why healthcare is so broken. They’re literally robbing us of our ability to BUY and INVENTORY drugs for our patients. HOW MESSED UP IS THIS!? #boycottCVS break up the PBMs. #PBMReform y’all, if your copays are high for generics, text or DM me, there’s a strong chance we can fill it for cash, without insurance for less than what these corrupt companies are forcing you to pay. — feeling fed up.
The top/biggest five PBM’s are own by insurance companies and or companies who have retail pharmacies AND mail order pharmacies. These PBM’s control about 80% of the Rx filled. I have heard rumors over the years… that Pharmas or wholesalers that have excess inventory that will expire in six months or less… they will offer the major mail order pharmacies some or all of their excess inventory at a “fire sale price”. I can assure you that these mail order firms have enough data on how much of a particular med/strength they sell on a average week and if they are offered some “close to expiration date” at a fire sale price… any smart business person would catch that “deal” and purchase enough so that they can expect to dispense those meds and out the door before the date they expire.
Most likely, only 20%-30% of a pharmacy’s inventory will be able to be “turned over in 30 days”. This may force Pharma or wholesalers to start offering meds in 30 tab/cap units. Most pharmacies are able to purchase meds from a wholesaler.. 5 days a week and Monday – Thursday the meds ordered before the wholesaler’s cut off time – typically around 5PM-6PM… the pharmacy will get their order the next day. This may make pts order their refills a couple of days ahead, because the pharmacy has stopped stocking “slow mover meds”
The more the states attempt to put some controls over the PBM’s … the more monopolist practices they “dream up”. As Congress talks more and more about reducing prescription prices… and the PBM industry conservatively causes Rx prices to be at least 40% higher than they would be without a PBM industry as a MIDDLEMAN. >50% of independent pharmacies are in towns with < 20,000 populations, so the most pts that are going to be harmed by end up living in a pharmacy desert and could be forced into using the PBM’s mail order pharmacies.
Filed under: General Problems
Our little pharmacy is gone,,,”Phillips,” gone,,bought by hospital,,,maryw