Throughout the week, I decided to log into our CVS Caremark portal to see the difference in reimbursements from our preferred pharmacy and the mail order pharmacy. What I discovered was alarming.
They charged a $0 copay on the front end. I now see the low copay is like a poisonous apple. As, behind the scenes, the part that we never take the time to look at is the cost that they charged the insurance for one month. The one month that they paid their own mail order pharmacy for one of my son's transplant medications was enough to pay for 10 months cash if I used another pharmacy and didn't use our insurance at all. Same manufacturer, same 1 month supply, & same dosage.
As they "steer" many of us to mail order pharmacy by not allowing us coverage to access our independent pharmacy, please know the insurance company isn't going take the hit for this price gouging and lack of choice. Who will? Tax payers will pay even more taxes when this is allowed in programs like Medicaid and Medicare. Yes, there are headlines of this happening in these programs. Also those who have employer sponsored health plans will be sure to see premiums rise if this continues.
There are comments from independent pharmacists (mom & pop pharmacies, hospital pharmacies, & small chain pharmacies) on our petition that briefly discusses this issue. They often hear the horror stories from patients regarding mail order pharmacy and they support our cause. They are being hit hard by the pharmacy benefit managers only allowing us to access mail order pharmacy. Then, they experience unfair reimbursements in the rare occasions patients do get access to their pharmacy. Sometimes, the reimbursement is so low that they it doesn't even cover their cost. This is causing pharmacies to close at a rapid rate.
As this happens, we should all be alarmed. Imagine only being allowed to go to one store to get your groceries. What do you think would happen to the cost of your food? By eliminating any other access to pharmacies other than those owned by our insurance companies pharmacy benefit manager often CVS Caremark, Express Scripts, Optum RX will have true consequences to drug cost, insurance cost, and most importantly, patient care.
The Columbus Dispatch recently posted a base drug cost tool (link below). The Columbus Dispatch are heroes just like our independent pharmacist who are revealing these issues.
The price is per pill/capsule. For my son's medication, the cost was about 20 cents per pill. Meaning that CVS paid their mail order pharmacy almost 14 times as much as the actual cost of the drug. They paid my preferred pharmacist who mostly handles delicate children's medications, less than 2 times as much as the drug's base cost, possibly not even enough for the pharmacy to come ahead after the cost of labeling, paying pharmacy staff, and and other business related fees.
Doesn't it seem backwards to pay independent pharmacies less when they offer more service through their face to face interaction and do not force us to only receive our medications on extremely hot and freezing non temperature controlled vehicles?
In honor and support of our independent pharmacies, hospital pharmacies, and our small chain pharmacies, Please share the petition!
As always you all are wonderful! Thank you for fighting beside patients like my son and many others,
Loretta Boesing