This helps explain why the PBMs want you to use their mail order pharmacy

This is a price quote from one of the major PBM’s websites and a Medicare Part D prgm.

The TOP PRICE is for 30 days supply and labeled as IN-STORE. The second price is for a 90-day supply labeled as MAIL ORDER. The mail order – I PRESUME – is the mail order pharmacy owned by the PBM managing the Part D Rx billing/payment.

Generally, mail-order pharmacies have a mandatory 90-day supply of all Rxs they fill. Would a prescriber willingly change the C-II they wrote for 30 days to a 90-day supply?

Would the fact that the mail order pharmacy wants to charge the pt 5-6 times the cost/dose of filling their Rx at a local community pharmacy?

According to GoodRx… the lowest quoted prices were $32 & $67 respectively for the two quantities.  Either one of those issues could cause the pt to go without their needed medication. The Prescriber is unwilling to prescribe a  90-day supply and/or the patient can’t afford the PRICE!

There is little question why the PBM industry is trying to run as many pharmacies – especially independent pharmacies – in rural areas. So that they can create an untold number of “pharmacy deserts” so that the PBM industry can “persuade” all these pts with no nearby pharmacies, to utilize their PBM mail-order pharmacies and more profits to their bottom line.

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