The FTC Awakens in the Fight for Pharmacy Competition
The link above is a great conversation between CEO Doug Hoey and Business of Pharmacy Podcast Host Mike Koelzer. Much of the conversation was about the Federal Trade Commission (FTC) taking an interest in pharmacy access issues. Pharmacy benefit managers (PBMs) such as Optum RX, Express Scripts, and CVS Caremark are responsible for overseeing reimbursements to their own pharmacies and their competitors. They also own their own mail order pharmacies that they force many to use as the only option of coverage.
The podcast discussed Express Scripts decision to remove 15,000 pharmacies from the Tricare network. Express Scripts is contracted to oversee the benefits for Tricare, which is for our military and veterans. Mark questioned Doug as to why Express Scripts would eliminate independent pharmacies from coverage. Why not just continue to reimburse these pharmacies below their costs?
The answer to that question is alarming, and I would be doing a disservice not to share the response with our supporters.
Doug Hoey, Pharmacist: Yeah, it was, they (Express Scripts) wanted 15,000 fewer pharmacies.
What they had in their agreement with, the Tricare Express Scripts Agreement shrunk the network.
Mike Koelzer, Host: Why? Why is that better for them than worse? If I'm running a network, I want more pharmacies, and I want to pay 'em dirt.
Doug Hoey, Pharmacist: Well, they want fewer and apparently to pay dirt at least below cost based on these things that were sent to us. One factor you have to keep in mind, that helps drive their logic is mail order,
Mike Koelzer, Host: Oh yes. I see. Now you'd rather have like very limited, so they go mailer. Gotcha.
Doug Hoey, Pharmacist: Right? You want as few as possible to drive that patient into mail order.
So that's how your behavior dictates things to, to steer patients into mail order.
Mike Koelzer, Host: But you know, that mail order must be a tough sell... I don't like this, but instead of making mail order free and the independent pharmacy, $30 copay or something like that, they're making a crapload of money when they can't play that game, and they actually have to basically close the doors of that place.
So to force 'em to mail order
Doug Hoey, Pharmacist: Yet consumers, unless they're coerced, most consumers don't want it. I mean, like, like 90 plus percent when it's a level playing field and they're not financially coerced or otherwise coerced.
They don't want mail order for their drugs. Yeah, maybe they want mail order for their Amazon packages, but they don't want it for their drugs. and why should they have to,but they can't even incentivize it, it's like it was decent, they would at least incentivize it. They incentivize it just by removing the competition. That's kind of the MO of the PBMs, is that if we can't compete and win, then we'll have one-sided contracts or we'll try to buy the competition or try to restrict competition. This kind of goes full circle to where we started with the FTC.
We are at a very critical point to save America's pharmacy access. As we are working hard to apply the pressure to stop the forcing to mail order pharmacies, the PBMs are using restricted networks and using below costs reimbursements to close the doors of our local pharmacies. Time is not on our side. Please keep the pressure on and the fight to save pharmacy access by reaching out to your legislators.
Thank you for your support,
Loretta Boesing
Share Your Story: loretta@uniteforsafemedications.com