It is obvious that the PBM industry is feeling the pressure from bureaucrats, politicians, and those who pay premiums for healthcare.
It is interesting that in this advertisement, CHASE, who claims to be the Prescription Benefit Manager (PBM). States that the patient will pay ~ 50% less than what they would have paid cash for their prescription.
Which may be TRUE – HOWEVER – what he doesn’t mention is that the PBM may be demanding up to 75% discount, rebate, or kickback off of the Average Wholesale Price -from the pharma so that they don’t make the pharma’s med a non-formulary med and would require your doctor to file a prior authorization to get the medication that your doctor prescribed for you covered.
“CHASE” also didn’t say that the PBM would charge your insurance company and/or your employer if your insurance is an ERISA prgm – where the employer is self-funding all medical cost for their employees and their family, maybe something like 5 to 10 times what they SAVED THE PATIENT from paying cash.
Recently Arkansas passed a law HB1150 prohibits state permits to pharmacies owned by pharmacy benefit managers effective Jan. 1, 2026. Here is CVS’ response CVS may close stores in Arkansas following law banning PBMs from owning pharmacies Because CVS owns Caremark, the largest PBM in the country and CVS has only 23 stores in Arkansas. Nationally CVS has about 9100 pharmacies in the USA. CVS has already scheduled to close 10% of its stores over the next 3 yrs.
CVS Will Close 900 Stores Over Next 3 Years, Convert to New Store Formats
Obviously, it is clear where CVS makes most of their profits. How many pharmacy deserts will closing those 900 pharmacies create?
The above TV is just one of many for the PBM industry – you just need to go to www.youtube.com and type in “prescription benefit manager tv ads” and see all the TV ads that come up for the PBM industry defending how they are saving you money.
Filed under: General Problems
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