Topic

Health Care

385 petitions

Update posted 8 hours ago

Petition to Doug Jones, Lisa Murkowski, Dan Sullivan, Kyrsten Sinema, Martha McSally, John Boozman, Tom Cotton, Dianne Feinstein, Kamala D. Harris, Michael F. Bennet, Cory Gardner, Richard Blumenthal, Christopher J. "Chris" Murphy, Thomas R. Carper, Christopher A. Coons, Marco Rubio, Rick Scott, Johnny Isakson, David Perdue, Mazie K. Hirono, Brian Schatz, Mike Crapo, James E. Risch, Tammy Duckworth, Todd Young, Chuck Grassley, Joni Ernst, Pat Roberts, Jerry Moran, Mitch McConnell, Rand Paul, Bill Cassidy, John Kennedy, Susan M. Collins, Angus S. King Jr., Benjamin L. Cardin, Chris Van Hollen, Elizabeth Warren, Ed Markey, Debbie Stabenow, Gary C. Peters, Amy Klobuchar, Tina Smith, Roger F. Wicker, Cindy Hyde-Smith, Roy Blunt, Jon Tester, Steve Daines, Deb Fischer, Ben Sasse, Catherine Cortez Masto, Jacky Rosen, Jeanne Shaheen, Maggie Hassan, Robert Menendez, Cory A. Booker, Tom Udall, Martin Heinrich, Charles E. Schumer, Kirsten E. Gillibrand, Richard Burr, Thom Tillis, John Hoeven, Kevin Cramer, Rob Portman, James M. Inhofe, James Lankford, Ron Wyden, Jeff Merkley, Jack Reed, Sheldon Whitehouse, Lindsey Graham, Tim Scott, John Thune, Mike Rounds, Lamar Alexander, Marsha Blackburn, Ted Cruz, Mike Lee, Bernard Sanders, Mark R. Warner, Tim Kaine, Patty Murray, Maria Cantwell, Joe Manchin III, Shelley Moore Capito, Ron Johnson, Tammy Baldwin, Michael B. Enzi, John Barrasso

Pay Independent and Hospital Pharmacists Fairly & Provide Access Through Coverage

Per a recent consumer reports study, most patients prefer independent pharmacy (Gill,2018). Unfortunately, many are not allowed to use independent pharmacy for coverage of their life-saving medications as pharmacy benefit managers such as CVS Caremark, Optum RX, and Express Scripts have removed this option from our coverage. Across our nation news reports are highlighting the price gouging that is occurring behind the scenes as we are being forced to their pharmacies. It appears, no one is listening to the voices of voters and patients. For example, recently medications that were filled by a hospital pharmacy were suddenly forced away from the hospital pharmacy to the insurance company's pharmacy benefit manager's owned mail-order pharmacy. It wasn't because our pharmacy was unqualified; they fill medications for children's transplant, cancer, and many other specialty medications every single day. The reply received from the insurance company's pharmacy benefit manager for the reason for denial stated that the pharmacy was not an appropriate location to fill these medications. Many would argue they were the most qualified and appropriate. The issue is the pharmacy benefit managers (PBM) who control access and reimbursements. There is about an 80 percent chance your PBM is Express Scripts Optum RX or CVS Caremark. Sadly, these same pharmacy benefit managers force many to their own mail-order and retail pharmacies. For my family, our only in-network pharmacy is CVS and CVS mail-order pharmacy. The PBM, of course, is CVS Caremark. Life-saving medications, like my son's transplant medications, are mandated to only be received through the mail for coverage. This issue is not unique. It's happening across America. Recently, a news article stated that CVS paid their own pharmacy much more. "For example, CVS would have to pay Walmart and Sam’s Club almost half again as much — 46 percent more — for generic drugs if CVS were to equal the rates it was paying its own pharmacies" (2019, Candisky & Schladen)" When looking at the reimbursements of our independent pharmacies, unfair and unequal reimbursements are found. "For a Fentanyl Patch 100, CVS pharmacies were reimbursed $400.65 while mom-and-pop pharmacies were reimbursed $75.74. For Amoxicillin, CVS pharmacies were reimbursed $35.92 while mom-and-pop pharmacies were reimbursed $12.21 (Lopez,2018)" Upon speaking to many pharmacists, these reimbursements are barely enough or not enough to cover their overhead cost along with the cost of the medications. After these unfair reimbursements Business Insider notes, "They also didn't know that, as their local pharmacists were getting squeezed, CVS was waiting in the wings, sending out letters offering to buy the very mom-and-pop shops it was forcing out of business (Lopez,2018)." In Ohio alone, over 160 independent pharmacies have closed. Many were bought out by CVS and many did not reopen. These closures are leaving entire communities at loss of a critical healthcare provider to help them demonstrate how to use complex medications, to inform patients that it may be cheaper to pay cash instead of using their insurance card, to prevent patients from taking the many risks of mail-order pharmacy such as delays, lost, thefts, loss of potency of medications due to lack of temperature monitoring, the risk of children and pets ingesting medications, and no one to communicate face to face with our elderly and people with chronic conditions and the list of over 100 other issues with mail-order pharmacy. The over-performance and hard work of our independent, hospital, and community pharmacist should be greatly rewarded not overlooked and disregarded. For example, CVS often states that they are paying per performance. For example, CVS states they pay the pharmacy based on factors such as patient adherence and use of generics. They often measure adherence by medications refilled by the customer. However, for some customers who are discarding medications by the table full due to auto refills and the price gouging of taxpayers dollars when generics are filled, many patients argue that the performance reward should go to our independent, community, and hospital pharmacy who do not make us take all the risks with mail-order pharmacy. Often, when a medication is refilled and the mail-order pharmacy has delayed the medication for days and weeks or one of many incidents that can go wrong with mail -order happens during shipment, the independent pharmacies will fill an emergency prescription. What will happen as the independent pharmacist close their businesses? Where will we go? The insurance company's pharmacy benefit managers are hoping that we are all sleeping at the wheel. That we are not caring about the future of our pharmaceutical care. Let's unite and the PBMs and our regulators otherwise!   YOUR SUPPORT WILL SAVE LIVES  Thank you! Loretta Boesing www.uniteforsafemedications.com Please make a tax-deductible donation to our advocacy and join with our trusted pharmacies who are working hard to fight against this unethical business practice.    References,  Candisky, Cathy, and Schladen, Marty, and . “CVS Paid Itself Far More than Some Major Competitors, Report Says.” Gatehouse Media, Gatehouse Media, 2019, gatehousenews.com/sideeffects/cvs-paid-far-major-competitors-report-says/. Gill, Lisa L. “Consumers Still Prefer Independent Pharmacies, CR's Ratings Show.” Product Reviews and Ratings - Consumer Reports, 7 Dec. 2018, www.consumerreports.org/pharmacies/consumers-still-prefer-independent-pharmacies-consumer-reports-ratings-show/ Lopez, Linette. “What CVS Is Doing to Mom-and-Pop Pharmacies in the US Will Make Your Blood Boil.” Business Insider, Business Insider, 30 Mar. 2018, www.businessinsider.com/cvs-squeezing-us-mom-and-pop-pharmacies-out-of-business-2018-3        

Loretta Boesing
6,822 supporters
Update posted 1 day ago

Petition to Jill Schupp, Terry Kilgore, U.S. Senate, Roy Blunt, Dan Brown, Kathy J. Byron, Lee Ware, Mike Cunningham, Timothy Hugo, Bill Eigel, Jason Holsman, Daniel Marshall, III, Jacob W Hummel, Robert B. Bell, Israel D. O'Quinn, Jamilah Nasheed, Bob Onder, Ron Richard, David E. Yancey, John Joseph Rizzo, Caleb Rowden, David Cameron MP, Margaret B. Ransone, Dave Schatz, Scott Sifton, Wayne Wallingford, Michael J. Webert, Paul Wieland, Richard C. Shelby, Doug Jones, Lisa Murkowski, Dan Sullivan, Tony O. Wilt, Jeff Flake, John Boozman, Tom Cotton, DIane Feinstein, Kamala D. Harris, Michael F. Bennet, Cory Gardner, Richard Blumenthal, Christopher T. Head, Thomas R. Carper, Christopher A. Coons, Bill Nelson, Marco Rubio, Johnny Isakson, David Perdue, Brian Schatz, Mazie K. Hirono, Mike Crapo, James E. Risch, Richard J. Durbin, Tammy Duckworth, Joe Donnelly, Todd Young, Jeion A. Ward, Joni Ernst, Pat Roberts, Jerry Moran, Mitch McConnell, Rand Paul, Bill Cassidy, Mark L. Keam, Susan M. Collins, Angus S. King Jr., Benjamin L. Cardin, Chris Van Hollen, Elizabeth Warren, Eileen Filler-Corn, Debbie Stabenow, Gary C. Peters, Amy Klobuchar, Tina Smith, Roger F. Wicker, Cindy Hyde-Smith, Jon Tester, Steve Daines, Deb Fischer, Benjamin Sasse, Dean Heller, Catherine Cortez Masto, Jeanne Shaheen, Margaret Wood Hassan, Robert Menendez, Cory A. Booker, Tom Udall, Martin Heinrich, Charles E. Schumer, Kirsten E. Gillibrand, Richard Burr, Thom Tillis, John Hoeven, Heidi Heitkamp, Kaye Kory, Joseph C. Lindsey, Lamont Bagby, Ron Wyden, Jeff Merkley, David J. Toscano, Steve E. Heretick, Jack Reed, Michael P. Mullin, Lindsey Graham, Tim Scott, John Thune, Mike Rounds, Lamar Alexander, Bob Corker, Jeffrey M. Bourne, Ted Cruz, Orrin G. Hatch, Mike Lee, Patrick J. Leahy, Bernie Sanders, Mark Warner, Tim Kaine, Patty Murray, Maria Cantwell, Joe Manchin III, Shelley Moore Capito, Ron Johnson, Tammy Baldwin, Michael B. Enzi, John Barrasso, President of the United States, Maria Chappelle-Nadal, Ann Wagner

Stop Forcing Mail-Order Pharmacy as the Only Option of Coverage

Patients' lives depend on choice. **Since starting the petition, I have realized that there are many issues other than temperatures with forced mail-order pharmacy.  Mail-order pharmacy is very loosely regulated. There are life-threatening delays, lack of face-to-face relationship with pharmacists for people with chronic conditions, and rapid closures of our independent pharmacies; although, a recent study showed people prefer independent pharmacy (2018, Gill).    *************Our Story************* Our son, received a life-saving liver transplant at the age of 2 from a 3-year-old little girl. His life depends on the potency and effectiveness of chemotherapy/immune suppression medications every 12 hours to prevent his body's immune system from fighting off his transplanted liver. In the past mail-order delivered his liquid oral medications in nothing but a plastic envelope on a 102-degree day on a hot enclosed not temperature controlled UPS truck. Shortly after, he went into liver rejection which could have resulted in complete liver failure or death. I speculated that the medication could have been too weak after the delivery of medications in high heat. I vowed to never again risk his life with mail order pharmacy. Recently, we were mandated/forced to only use mail-order pharmacy in order to receive coverage for his life-saving medications.  The package arrived in only a bag on a hot day without an ice pack. The hot non-temperature controlled enclosed delivery truck can reach temperatures up to 170 degrees. His labs elevated again afterward. My son wants to know, "Why would they do that?" I contacted the manufacturer, who performs the testing stated that both of my son's medications should be discarded and considered less potent once stored above 86 degrees as higher temperatures and freezing could both result in lower potency. Liquid medication is the most harmed by the mishandling of medications outside of the manufactures temperature storage guidelines.  I contacted the mail-order pharmacy who refused to replace or take back the medication. They said the law & USP Pharmacopoeia allows them to ship up to 104 degrees, although the manufacturer states it is not proven safe at these temperatures. However, I have received communication from USP Pharmacopoeia who writes guidelines for storage, and they also said that the mail order pharmacy should follow the manufacturer's guidelines of 59-86 degrees for storage. Again, the trucks reach up to 170 degrees which is much hotter than 104.  I contacted the FDA, who states that the mail order pharmacy should be using the manufacturer's guidelines that have been proven safe..However, since the mail-order pharmacies are regulated loosely by the State Board of Pharmacy, not the FDA there was nothing that the FDA could do.  I made over 30 calls to the insurance company begging for them to please let us pick my son's medications up at the local pharmacy at which they are filled. My son's physician wrote a note/appeal as his transplant team has stated that they have tried to voice their concerns about this issue with their pediatric/child patients and no one is listening! The insurance company still denied the doctor's appeal for us to pick up my son's medications in the safest way. It was not until the Media became evolved that the insurance company budged.  I felt helpless and have united with many other pharmacists, physicians, patients, mothers and fathers, and caregivers who feel the same way. Helpless. Mail-order of prescription drugs should be a choice, not the only option of coverage.  Mail-order pharmacies may appear to save money, but when my son ended up in the hospital after taking medications that could have been compromised by having lower potency, the cost of the rejection was thousands of dollars. If his liver would have fully failed, the cost of his liver transplant for just 5 days (he was in the hospital for 5 weeks) was over $1,000,000. The lax regulation and oversight may save money on prescription drug plans but may come at an increased cost to the health plan itself. Also, keep in mind the endless waste of medications that automatically are sent regardless of whether or not patients need them. Also, people with chronic, complex conditions, should always have the option of face to face interaction with a pharmacist who knows their complex needs and medical history. The pharmacist and patient relationship is crucial to the successful outcome of the patient's overall health. Taking this away is harmful to patients and be more costly to our already stressed healthcare system. Another important fact. Mandatory mail-order programs are discriminatory. It is estimated that 40% of the homeless are disabled. How is mandatory mail order fair and working for them as they may not have an address and not even know where they will be from day to day? Only allowing mail-order pharmacy for coverage is unethical and irresponsible. I share stories on my social media sites every day of patients who are suffering from lack of choice.  We need your help to make mandatory mail-order an option, not a mandate.  If you are interested in sharing your story or concerns with regulators and State Boards of Pharmacy, please let me know. Remember to include your state! Email: loretta@uniteforsafemeds.com Facebook Page: Issues with Mail Order Pharmacy @justamomwholovesherson Twitter: @BoesingLoretta The greatest way that you can help is by sharing this petition & gathering 2-3 people in your community who are having issues and speak to your legislatures.  YOUR URGENT SUPPORT WILL SAVE LIVES! THANK YOU!! WE APPRECIATE ALL OF THE SUPPORTERS, CAREGIVERS, & PATIENTS.  Reference: Gill, Lisa L. “Consumers Still Prefer Independent Pharmacies, CR's Ratings Show.” Product Reviews and Ratings - Consumer Reports, 7 Dec. 2018, www.consumerreports.org/pharmacies/consumers-still-prefer-independent-pharmacies-consumer-reports-ratings-show/

Loretta Boesing
81,486 supporters