Dear supporter,

A government report found that when it came to generic specialty drugs and steering to their own mail order pharmacies, pharmacy benefit managers (PBMs) Optum RX, CVS Caremark, & Express Scripts are reimbursing themselves many times over the cost of a medications resulting in huge profits for the insurance companies that they merged with. 

Forcing to mail order pharmacy isn't about what's safer or more affordable. Per  Marty Schladen among the report stated:

1. Between 2020 and 2022, the big PBMs’ affiliated pharmacies marked up 63% of the specialty generics they dispensed 100% or more over National Average Drug Acquisition Cost. Twenty two percent were marked up 1,000% or more.
2. The big PBMs “almost always” reimbursed their affiliated pharmacies at higher rates than their competitors, the report said. The disparity was greater in cases where commercial insurance was involved than when Medicare Part D was the payer.
3. Between 2020 and 2022, PBM-affiliated pharmacies dispensed 72% of all drugs marked up by $1,000 or more, while they dispensed just 44% of all generic specialty drugs during that period. “Dispensing patterns suggest that the Big 3 PBMs may be steering highly profitable prescriptions to their own affiliated pharmacies (and away from unaffiliated pharmacies),” the report said.
4. The big three PBMs generated an additional $1.4 billion by charging more for drugs than they paid the pharmacies that dispensed them. Such “spread” pricing ignited a furor in Ohio in 2018, when it was revealed that CVS Caremark and OptumRx billed the state Medicaid system $224 million more for drugs than it paid pharmacies the previous year.
5. Dispensing marked-up drugs from affiliated pharmacies is a key business for their parent companies: UnitedHealth Group, CVS Health and Cigna-Express Scripts. Each of those companies are among the 20 largest in the country and sales from their mail-order pharmacies account for a whopping 12% of their operating profit, the FTC report said.

When this price gouging occurs with our tax dollars, it's a huge waste that hurts patients and our communities as pharmacies rapidly close.

We now have a Department of Government Efficiency who claims their goal is to cut out wasteful spending. Let's put them to the test! If DOGE truly cares about cutting wasteful spending, stopping the PBMs from price gouging as they force to their own mail order pharmacies should be easy for them to do. So let's challenge them by signing this new petition to DOGE. 

Thank you all for your support, 

Loretta Boesing, Patient Advocacy

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