Is there a conspiracy to replace Pharmacists with Robo-Dispensers

Jp Enlarged

Clearly, this writer is not a pharmacist.  He is angry.  He insults pharmacists, as a group.  His language is over-the-top and he is assured of two things.  He will piss pharmacists off and he takes a chance of being completely disregarded.  

But, you know what?  He is right down the line on target.  When I was walking Buddy this morning, I was playing with ideas on how to approach the differentiation between ROBO-DISPENSERS and PHARMACISTS.  You know the difference.  What I want to explore is WHY this has happened and WHO BENEFITS.

The chain, big box and grocery store retailers do NOT NEED pharmacists.  They do not want an R.Ph. to leave the prescription mill to counsel on OTC choices.  They do nothing to support RPHs in complying with federal and state law.  All they want is for you to keep your nose in the Prescription Mill, making the numbers, happifying the MBA Masters of the Universe.  You all know EXACTLY what has been happening for the last decade.

The WHY is money.  Of course.  It always is.  The HOW is much more complex.  It took collusion, I think.  The word is defined:  Secret cooperation between people in order to do something illegal or underhanded .  Can we hope for a whistle-blower?  Collusion between the Retailers, ACPE, NABP, the Boards and possibly the schools.  Maybe not U.C. San Francisco because the traditional schools will always train PHARMACISTS.  The new schools aren’t in the business to educate pharmacists.  They are invested in creating people capable of working in a dispensary.  Can you imagine a grand conspiracy to transform the face of American pharmacy?  I can because I know what we have been getting.  I worked for awhile with a young woman who was educated at a new school.  She was a sponge and eagerly listened to anything I would share.

Is Jay Pee blowing smoke here, drinking the Kool Aid?  Do we have any chance of stopping this when Big Evil and Big Stupid and possibly Big Question are getting rid of veteran pharmacists and replacing them with lower-wage Robo-Dispensers?  The following is a comment from a critic who is a patient with a good, critical eye.

My holy god you people are a bunch of whiny faggots. Some of you write comments and can’t distinguish properly between THERE, THEIR, and THEY’RE… but you want to go on and on about how I should let YOU compound some bullshit medicine for me and how fucking lovely that really is and yes, you should make TEN ZILLION dollars per hour and NOT be exempt.

Puh-leeze… If you guys had any integrity, you would INSIST that they take that AIRBORNE crap off the shelves, as well as anything labeled “HOMEOPATHIC”… you and I know that the number 1 requirement for anything to be labeled “homeopathic” is that it not contain any active ingredients. Occilloscululanimousucum? Duck Liver extract to cure the common cold? In a 1 x 10^-30 dilution such that there is perhaps 1 molecule of “duck liver shit” in the bottle? REALLY? Go take your indignation and stick it where the sun don’t shine.

I’ve asked pharmacists about these nail fungus products that are all clearly labeled “will not cure nail fungus” on the back and “For Nail Fungus” on the front, and what do I get??? HUH? DUH??? what was that you said? No, not just one pharmacist… just about every one I have asked has said the same thing.

Your rant is just coming from a pissed off place because, in reality, you HAVE been replaced by a pill-counting and dispensing machine. You don’t pilfer the “occasional lorazepam” if you are a machine, I would suspect. So, speaking of which, doesn’t that make you a shit sucking unethical pillpopping leach? Why U No go See doctor? You too full of self, that why!! You smarter than doctor, of course.

And what’s this BS about pharmacists not being taught the study of making drugs from native plants and what not? WHY THE FUCK do I want you to know that? You are not a pharma! I have enough liver damage from all that stupid “Traditional” chinese medicine, based all on a bullshit theory of the body involving humor inbalance in the chi energies. Sounds a lot like sanguinicity and melancholy… sound familiar?

You make me sick.

Literally.

43 Comments

43 Comments

  1. broncofan7  •  Sep 30, 2013 @7:53 pm

    Nothing to see here Mr. Plagakis. Just another disgruntled Pharmacy Technician or child of a Pharmacist who obviously couldn’t get accepted into one of the now 129 Pharmacy schools in the USA and someone who obviously doesn’t realize that unless a Pharmacist OWNS the store that employs them, they have absolutely ZERO control over the stocking of OTC products. BF7

  2. Peon  •  Oct 1, 2013 @12:06 am

    I have no control over what Wal-Mart stocks in front of the pharmacy. However, I do have control over what I say to a customer when they ask about Airbourne, a homeopathic product, or a diet pill. I tell them it is crap and there to get their money.

  3. Pharmacist Bob  •  Oct 1, 2013 @12:54 am

    Some good points here from the observer of our profession. The companies make a profit on “anything that sells”, including the homeopaths, it does not matter if it is good for you or if it works, how much money is the bottom line. If we as a profession had a say in such matters, they would be gone. Have not seen a homeopathic remedy for aids yet.
    I believe CVS talks about reinventing pharmacy. Who gave them the right to reinvent pharmacy, and create robo pharmacists that have to answer to hundreds if not thousands of metrics of profit and call it “reinventing pharmacy”?

  4. bcmigal  •  Oct 1, 2013 @2:37 pm

    a bit off topic, but here is an article that I found almost humorous;

    http://drugtopics.modernmedicine.com/node/374211

  5. Pharmaciststeve  •  Oct 2, 2013 @11:07 pm

    TOMORROW… TOMORROW… TOMORROW .. SPEAK UP !
    October 3rd Tweet-a-Thon for #Pharmacist is tomorrow !
    https://www.facebook.com/events/490468714382945

  6. broncofan7  •  Oct 3, 2013 @4:45 pm

    I have it on VERY good authority that a mail order PBM that has been in the news in the last few years for acquiring other large PBMs is now requiring their Pharmacists to verify 177 rx PER HOUR. ONE HUNDRED SEVENTY SEVEN PRESCRIPTIONS EVERY HOUR.

    This is not hyperbole. This is their GOAL METRIC. Is their a conspiracy to turn us into Robo-dispensers?? No,it’s no conspiracy. It’s what happens when BIG BUSINESS/ Non-Pharmacists get into the the driver’s seat of our profession. When you don’t own the financials of your profession it’s not really YOUR profession….

  7. broncofan7  •  Oct 3, 2013 @7:56 pm

    that’s when working from the “e-prescribe queue” at this PBM owned mail order operation….

  8. Pharmaciststeve  •  Oct 3, 2013 @8:38 pm

    Some time back..it was rumored that WAGS and their POWER SYSTEM was wanting RPH’s to verify and do MTM in 12 seconds. If my math is right.. that is 300/hr..

  9. Goose  •  Oct 4, 2013 @9:48 am

    If all you are doing on that job is verifying scripts, that takes less time tahn filling one but medication reconcilliation and therapy management takes longer than that.
    In these systems that are making you a “robo-dispenser” , the opportunity would be in being a third party providing MTM soon after dispensing in a follow-up role.
    Look, it is well established that the point of sale in a pharmacy is not a good place to counsel. There are distractions and people are usually in a hurry.
    A spot check at dispensing to insure that there are no serious drug interactions and a quick verification on correctness of therapy is all that is INITIALLY needed.
    The real value would be in the followup- that would be our ideal role.

  10. AJ  •  Oct 5, 2013 @6:08 pm

    Left out were the retail chains that sell cigarettes and chewing tobbaco. Whole lot of healthy there.
    .
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    No conspiracy JP. It’s an intentional and well thought out plan by the big corporate retail chains. Dumb down the profession and convince the public all we do is take pills from big bottles and put them in little bottles. Soon you have everyone convinced pharmacists are expensive and unneccessary.
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    JP you see it everytime you go into a pharmacy. Hell at CVS everyone from the pimple faced high school clerk stocking candy to the pharmacist wear the same white lab coat. I can’t remember the last time a pharmacist spoke to me when picking up meds let alone do something crazy like counsel me. In fact the only time in the last 2 years I was “counseled” on medications was by a kid who looked about 18 wearing a white lab coat with a name tag that had clerk written on it in pencil. This was my first time at the pharmacy and I was picking up nebulizer meds and steriods for my daughter after she was hospitalized with croup. My “counseling” was “ummm, yeah like you know, I think this one might need to go in the refridgerator. I can ask the pharmacist if you want but there should be a sticker on it.” The whole time the pharmacist was standing 5 feet behind him busy cranking out those scripts and never looked up.
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    Sorry to break it to you JP but the public has already crossed the bridge on thinking pharmacists are worthless.

  11. AJ  •  Oct 5, 2013 @6:20 pm

    I have a better one for you guys. A few years ago I worked for a grocery store chain owned by Safeway. Some corporate genius decided to put a rack right beside the cash register with a sign topper that read “Pharmacist Recommended”. Every week the products would rotate based on the weekly ad. Of course a corporate program run by a bunch of non-pharmacist jack asses had its metrics. We had a weekly quota of products we had to sell off this rack. Mind you we had no input into what was put on this rack. Didn’t matter if it was a product we would recommend or not. These idiots put tooth brushes on it one week. Really?

  12. AJ  •  Oct 5, 2013 @7:00 pm

    I will throw one more comment out there…
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    I’m embarrassed to tell people I’m a pharmacist. I know what the average Joe experiences at the pharmacy because it’s the same experience I have. It’s a joke and I’m embarrassed to be associated with it.
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    I can read the look on their faces after I tell them what I do. First its ohhh you make a lot of money. Then there’s this brief look of anger and frustration as they remember all the bad experiences they’ve had at the pharmacy. Long lines, rude employees, prescriptions never ready, out of stocks ect. Then we move on to another topic.

  13. broncofan7  •  Oct 7, 2013 @2:23 pm

    I’m embarrassed to admit that you’re ACTUALLY a Pharmacist too Arden…….

  14. AJ  •  Oct 7, 2013 @8:44 pm

    Why is that broncofan7? Because I tell the truth? It hurts I know…

  15. AJ  •  Oct 7, 2013 @8:52 pm

    Broncofan7 your little pharmacy in the middle of BFE West Texas is an anachronism. Retail pharmacy is in a death spiral. It won’t be long before even your little anomaly in West Texas will get caught up in it.

  16. AJ  •  Oct 7, 2013 @9:37 pm

    Oh, I almost forgot, thank you for the kind words Brian….

  17. Broncofan7  •  Oct 8, 2013 @10:23 am

    Pharmacies (plural) :-) …..and more to come. Keep that that defeatist attitude AJ. I’ll keep creating a positive work environment for my employees, a personable 1st class service operation for my patients and a strong financial foundation for my family. Community pharmacy is the backbone of our profession….and you’re embarrassed by it. Yet you are drawing a paycheck from a PBM who is actively taking part in ruining our profession and is a driving force behind creating the subpar working conditions that many on this blog write about daily by creating artificial financial pressures through MAC pricing and also mandating the use of mail order for maintenance medications. If you’re a willful employee of a PBM you’re part of our profession’s problem.

  18. broncofan7  •  Oct 8, 2013 @11:11 am
  19. Broncofan7  •  Oct 8, 2013 @1:59 pm

    Here’s another informative link for those pharmacists who’d like to empower themselves….http://www.ncpanet.org/pdf/digest/2012/2012_digest_inbrief.pdf

  20. Broncofan7  •  Oct 8, 2013 @2:03 pm
  21. Broncofan7  •  Oct 8, 2013 @5:13 pm

    Some people like to complain while offering no solutions. Others are constructive in their posts. AJ complains about community pharmacy, insults community pharmacy, terms compounding a greedy scam all the while being employed by one of the main causes of the decline of professional satisfaction for many pharmacists, the PBM. He is embarrassed by his profession so he’s taking an active role in the destruction of it.

  22. Broncofan7  •  Oct 8, 2013 @5:29 pm

    Processing prior authorizations ( shuffling papers) IS NOT practicing pharmacy.

  23. AJ  •  Oct 9, 2013 @8:02 am

    Proof reading prescription data entry of a technician and verifying the picture on the screen matches the pills in a vial a technician filled while bypassing the DUR screens as fast as you can without reading them sure as hell isn’t practicing pharmacy either.
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    You don’t understand a damn thing that’s going on right now do you broncoidiot7? Your little anomaly of a pharmacy in West Texas is the exception to the norm. 99% of people in Texas fill prescriptions at major retail chains. You’re God damn right I’m embarrassed to be associated with what those chains have done to the profession. Go back and slowly read my posts and you will see I’ve blasted the corporate retail chains that have ruined the profession.

  24. broncofan7  •  Oct 9, 2013 @9:22 am

    Wrong again AJ.Oversight of the dispensing of the prescription process (right medication, right patient, right dose, etc.) is in fact the practice of pharmacy, along with counseling patients on OTC medication questions, loaning Mr. Smith 3 levothyroxine because his MD hasn’t yet responded to our 3rd fax refill request and calling the physician over a dosing error are also squeezed into the normal day of a practicing Pharmacist.

    But do you know what the true litmus test is to see if you are truly practicing Pharmacy or not? It’s in your professional liability. As a Prior Authorization “Pharmacist” you have N-O-N-E. If a PA request actually met criteria for approval but somehow didn’t get approved in the time limit allotted, you may receive sanction from your PBM employer but the TSBP can’t sanction your license despite your error that caused a physician and patient to have to seek another treatment modality. You are NOT practicing Pharmacy; your an administrative worker working on behalf of a company that creates it “formulary” on the basis of whether or not a manufacturer will PAY THEM KICKBACKS to put a medication on their “formulary” (IE Nexium instead of Aciphex/Dexilant.)

    AJ: “retail Pharmacy is in a death spiral”—AND “99% of people in TEXAS (that’d be 26 MILLION PEOPLE) fill their prescriptions at major retail chains.” 99% of people DON’T use chains first of all and secondly even if they did, why would there be a CVS and Walgreens on every corner if “retail pharmacy is in a death spiral”? PBMs like your employer are the chief responsible party in the declining work environment for Pharmacists via 1)the artificial market pressures that they bring to Retail Pharmacy by their MAC pricing list 2) by data mining and stealing patient data from retail pharmacies and mailing patients letters after every fill at retail to try and get them to switch to go to their PBM owned Mailorder operation and 3) by mandating the use of mail order for large employer groups and specialty medications (Enbrel, Humira) that have great GROSS DOLLAR MARGINS.

    For an employee of a PBM to come onto this blog and then post about the decline of retail pharmacy, state that he is embarrassed by it and who also called compounding a greedy scam, is like a shift manager employee at a coal plant in China complaining about air pollution….

  25. broncofan7  •  Oct 9, 2013 @9:47 am

    and I quote:

    http://www.jimplagakis.com/?p=6487

    “AJ

    August 17, 2013 at 10:39 pm

    Jim, compounding is a money making scam. 99% of all compounded meds are unnecessary and done solely for the money. It’s interesting they have been able to fly under the radar so long. Thanks to some really shady and greedy outfits the scam is over. Most of these big outfits shipping prescriptions across state lines are manufacturing plain and simple. Trust me the insurance companies are going to shut down payment for them as well.”

  26. broncofan7  •  Oct 9, 2013 @11:15 am

    and the busiest Pharmacy in Midland, TX (population: 120,000) is an independent.

  27. Steve Moore  •  Oct 9, 2013 @1:04 pm

    I think we can safely blame the chains/mass merchandisers and the PBMs for a alot of our issues. That being said, a lot of pharmacists let a lot of little things happen that eventually led us to this point. Pharmacy will be better off as more and more pharmacists take ownership of their profession. I don’t mean everyone has to go out and buy a pharmacy, but more pharmacists need to really think about the effect their actions and/or those of their employer have on the profession. We are stewards of the profession and have an obligation to leave it better than we found it.

    Anyway, I just received the following from another pharmacy owner. I don’t know who this PBM expects to actually fill prescriptions for them given these terms. Oh wait, they are owned by a large pharmacy and they probably get a better rate. I find it hard to blame pharmacy when PBMs are coming to the table with offers like this. At least until someone signs the contract that is.

    “I was told by my PSAO rep that the DIR fee to be preferred with PBM XYZ for 2014 will be 5.25% of total prescription price. So I just looked up the NCPA digest figures for 2011 (the latest I could find) show the average pharmacies net operating income as 2.9%. What pharmacist in his right mind would want to pay more money on each prescription he fills that what his net operating income would be on that prescription? I just looked at my average prescription price for last month which was $47.91 so that is $2.51 per prescription. My dispensing fee for this PBM is $2.25 so I would be paying them more per prescription than they are paying me.”

  28. broncofan7  •  Oct 9, 2013 @6:17 pm

    Mr Moore, you provide a perfect example of why a firewall must be put between Pharmacy insurance and the delivery of prescription Pharmacy services. Does AETNA own it’s own hospital or chain of medical clinics? How about united health? So why does the Pharmacy industry allow insurance companies to own dispensaries? Further, collusion between the PBM’s and large chain stores (preferred networks like the one you note above) are anti competitive on their face and the worst part of all? We are paying for the PIE via taxes that these PBM’s are divvying up via preferred contracts with specific large chains! One Pharmacy group has challenged the validity of preferred Pharmacy networks and had their initial claim thrown our of lower courts as the lower court didn’t feel as though that the pharmacy group had “proper standing” to bring suit against CMS…It’s dumbfounding how crooked attorneys crafting these anticompetitive contracts for PBMs have gotten away with this so far…if they continue to get their way, we are all going to be relegated to employee status and we will be treated even more poorly via work conditions than we are now.

  29. broncofan7  •  Oct 9, 2013 @6:31 pm

    Further, there are over 3000 Health Mart stores nationwide; Health Mart should be leveraging their #’s to get better reimbursement via their Access Health PSAO but can’t because of certain laws…..because as you stated, there no way the X Y Z Pharmacy/PBM isn’t simply playing with their balance sheet in order to make this seem justifiable…..

  30. AJ  •  Oct 9, 2013 @7:43 pm

    You guys are blaming the symptoms for all your problems while ignoring the disease that’s killing you.
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    Let’s play a game and use broncofan7′s logic on some everyday issues.
    .
    It’s not the bank robber’s fault for robbing the bank it’s the banks fault for being there.
    .
    It’s not the alcoholics fault for drinking. It’s the liquor stores fault for selling the alcohol.
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    It’s not the fat ass type II diabetic whose at fault for his condition it’s the spoons fault for providing a means to shove more food in his mouth.

  31. AJ  •  Oct 9, 2013 @8:19 pm

    Broncofan your lack of understanding of this industry is laughable!

    Your little pea brain is so focused one narrow little thing. The big bad terrible PBM!!!!! I hate to break this to you but every single damn insurance company either owns a PBM, handles PBM functions in house or contracts with a stand alone PBM. EVERY FREAKING SINGLE ONE. Most also own a mail order outfit as well. You complete lack of understanding of how the industry works is shocking.
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    Kaiser Permanente is the largest managed care organization in the United States. Kaiser Foundation Hospitals operates medical centers in California, Oregon and Hawaii, and outpatient facilities in the remaining Kaiser Permanente regions.
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    Aetna has mail-order pharmacies and a specialty mail order pharmacy in Kansas City, Mo., and Pompono Beach Florida. Aetna Rx Home Delivery fills more than 500,000 prescriptions monthly
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    Humana has a division called Humana Pharmacy Solutions PBM. You can also get your prescriptions delivered with Humana’s RightSource mail-order service.
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    UnitedHealth Group owns a PBM called OptimRx.
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    Blue Cross Blue Shield of Illinois has Prime Therapeutics LLC. in Eagan, Minnesota. The company is privately held by organizations representing 14 Blue Cross and Blue Shield (BCBS) plans in Alabama, Florida, Illinois, Kansas, Minnesota, Montana, Nebraska, New Jersey, New Mexico, North Carolina, North Dakota, Oklahoma, Texas and Wyoming.
    .
    Anthem’s has an in-house pharmacy benefit manager (PBM). Who uses pharmacy claim data, to identify at-risk members in earlier, more treatable stages. Our in-house pharmacy benefit manager (PBM) can also share prescription histories with doctors to help reduce adverse drug interactions.
    .
    Anthem Rx Direct mail service pharmacy — Employees can save time and money by having up to a 90-day supply of their maintenance medications delivered directly to their homes, offices or other location of choice.

  32. AJ  •  Oct 9, 2013 @8:34 pm

    The entire system would have collapsed years ago if it weren’t for the insurance industries utilization management of prescription and medical benefits. That’s a fact.

  33. RetailRPh  •  Oct 9, 2013 @8:57 pm

    I’ve never seen/heard such disrespect towards fellow pharmacists & the profession as I have from AJ over the last few months that I’ve followed JP’s site. AJ, you bring nothing positive to the discussion. If you hate pharmacy so much, why even work as one? If you even call what you do being a pharmacist. Broncofan summed up my sentiments perfectly in his rebuttal. I work for a chain & I still have customers who appreciate what I do & I’m sure they see what I do as practicing pharmacy: ensuring they get correct medication, correct & proper dose, with no drug interactions & brief counseling on effective use of the meds. Many times, I’ll even call their dr to suggest lower cost effective options to help them save money. And, we do that with dozens of distractions all around us. That, my friend, IS practicing pharmacy. You looking at a formulary & deciding whether someone has tried & failed two previous generic NSAIDs before approving Celebrex is what a paper pusher does. Anybody with half a brain can do what you do!
    My advice for you is: please bring something constructive to the discussion. Talk about how to move the profession forward.
    Oh and by the way, when someone asks what I do for a living, I PROUDLY tell them I’m a pharmacist. And so is my wife!

  34. Pharmaciststeve  •  Oct 9, 2013 @10:36 pm

    The entire insurance industry prevails and prospers on two issues and/or loop holes.

    Once the meds are dropped into a courier service (USPS, UPS, FEDX).. the FDA/USP temp storage requirements no longer have to be maintained..

    The McCarren/Ferguson act exempts the insurance industry from The Sherman Antitrust Act.. which allows the insurance industry to do things that if other business tried.. FTC/Justice would charge them with market manipulation and/or collusion..

    Amazing that Rx prices were extremely stable until two things happened.. the “drug cards” started to arriving on the scene and bureaucrats started forcing the use of generics.

    It you applied the CPI to the average Rx price in the 60′s.. when wholesale prices were nearly static… today you would have a price in the 25-35 range.. and isn’t this just where the averages for generics are today ?

    It doesn’t take a MBA to know that the more middlemen you have in a distribution channel.. the higher the price the end user ends up paying.

  35. broncofan7  •  Oct 9, 2013 @11:45 pm

    “The entire system would have collapsed years ago if it weren’t for the insurance industries utilization management of prescription and medical benefits. That’s a fact.”

    Pure idiocy.

  36. broncofan7  •  Oct 9, 2013 @11:49 pm

    “Kaiser Permanente is the largest managed care organization in the United States. Kaiser Foundation Hospitals operates medical centers in California, Oregon and Hawaii, and outpatient facilities in the remaining Kaiser Permanente regions”

    In the rest of the US, we have Aetna, unite health, and blue cross among others. Now does Kaiser data mine and poach from insured customers their visits to other competing hospitals and clinics and then attempt to contact them to go to a Kaiser owned clinic/hospital and incentivize their customers with copay discounts? Because that is what is happening in EVERY state in the USA not just CA, HI and a few other west coast states.

    The rest of your post is nonsensical and off point. how you derived that I thought that insurance companies don’t own or contract out their PBM services is beyond me. But you continue to defy logic with every keystroke….

  37. broncofan7  •  Oct 10, 2013 @12:00 am

    Steve is right on point with his post.

    AJ on the other hand continues to attempt to have an understanding of the BUSINESS of Pharmacy that he simply never will have without being an owner. He’s not CEO or CFO of a certain PBM….he’s a lead of a team of techs in a PA department processing PA calls. I used to know the old supervisor of the department he works in. Further experience as a PIC at a chain store also does not prepare you as the PIC has ZERO idea of what his company is truly paying for medications(not privy to wholesaler rebate discounts) doesn’t do reconciliation of insurance checks, doesn’t negotiate 3rd party contracts, and doesn’t have to manage the budget and make a $250K drug bill on top of employee hours, paying the electric bill, etc etc.
    AJ still insists that PBM’s are fighting the good fight and saved our “entire system”…that’s all you need to know about his mental acuity in relation to the BUSINESS of community Pharmacy. But if you want to have someone regurgitate the PBM derived “clinical guideline” and explain to you why Nexium is formulary and Aciphex isn’t, he’s your man!
    ….

  38. broncofan7  •  Oct 10, 2013 @10:25 am

    Here’s an excellent article on the deleterious affects that PBMs have on our profession:

    http://www.pharmacistactivist.com/2013/August_2013.shtml

    “The pharmacy benefit managers (PBMs) and insurance companies that are the primary advocates for mail-order pharmacy have been successful in perpetuating what I consider to be a myth that obtaining prescriptions from mail-order pharmacies is less expensive than obtaining prescriptions from local pharmacies. Because it is only the PBMs and insurance companies that have the pertinent data (designated as proprietary to avoid providing it to others) and dictate the financial terms of prescription benefit programs, they are in a position to manage/manipulate this information to their advantage. Advocates for local pharmacies have had only very limited success in refuting this message.

    An issue for our entire profession
    Many within pharmacy consider mail-order pharmacy to be an issue that only affects community pharmacy. I contend that it is of importance for our entire profession for reasons that go beyond the fact that community pharmacy is by far the largest area of pharmacy practice and, therefore, is the experience through which most of the public relate to and identify the profession of pharmacy.

  39. Pharmaciststeve  •  Oct 10, 2013 @6:48 pm

    http://money.cnn.com/2013/10/10/news/companies/pbm-pharma-management.pr.fortune/
    Express Script charges employer over THREE TIMES what it paid the pharmacy to fill a Rx..
    PBM saving money for the system ???

  40. broncofan7  •  Oct 10, 2013 @9:05 pm

    Great find Steve!

    but without PBM’s,according to one esteemed poster above, “The entire system would have collapsed years ago if it weren’t for the insurance industries utilization management of prescription and medical benefits. That’s a fact.”

    :-)

  41. Broncofan7  •  Oct 13, 2013 @5:00 pm

    AJ: here are some macro statistics on independent pharmacy…….

    The National Community Pharmacists Association (NCPA®) represents the interests of America’s community pharmacists, including the owners of more than 23,000 independent community pharmacies. Together they represent an $88.7 billion health care marketplace, dispense nearly 40% of all retail prescriptions, and employ more than 300,000 individuals, including over 62,000 pharmacists. To learn more go to http://www.ncpanet.org.

  42. broncofan7  •  Oct 16, 2013 @1:38 pm

    Here’s a new article focusing on the deceitful and harmful practices of some PBMs………http://www.workforce.com/articles/19960-the-pill-game

  43. broncofan7  •  Oct 16, 2013 @1:40 pm

    http://www.workforce.com/articles/19960-the-pill-game

    “The fundamental elements for a competitive market are transparency, choice and a lack of conflicts of interest. The PBM industry fails on all three dimensions. There are relatively few choices, and there isn’t transparency. It’s the one profoundly unregulated area in the health care market.”

    SPOT ON.

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