if you are not paying attention to what is going on in healthcare. Many of the major players OR major players WANNABE…are doing what is called vertical integration. “they” are creating “healthcare deserts” and “healthcare oases”. Most of the “deserts” will be in rural areas. The Prescription Benefit Managers “control” the Rx market place. CVS Health/Caremark has 33% of the ENTIRE RX MARKET… almost 10% above “second place” PBM of market share. The top 4 PBM’s control almost 70% of the Rx market and the TOP TEN control abt 97% of the Rx market.
Just do a web search for the word “Caremark sued” and see hold many times Caremark is being sued over overcharging. Several years ago, the State Treasurer of Arkansas and the State Pharmacy Assoc did a price survey of the state employees medication insurance program, managed by Caremark. They looks at some 250 different Rx medications. What they found was that when a state employee filled a Rx at a CVS pharmacy as opposed to an employee filling the same medication/strength/quantity at a pharmacy that was a competitor of CVS… That the CVS pharmacy was PAID – ON AVERAGE – abt $60.00 more per Rx.
When the actual cost of filling a Rx.. generally falls in the $12.00 to $15.00 range – covers labor, utilities, rent, insurance, etc. So on average, in this survey, the CVS pharmacies were paid > FOUR TIMES the cost/overhead of filling a Rx.
How these “pharmacy desert” are created… is that there is some manipulating of reimbursing of particularly independent pharmacies – by the PBM – until they go out of business.. a local independent that closed a few months back near me… stated that abt 50% of all the Rxs filled, they were reimbursed at abt 50% of what it cost to buy the medication from the wholesaler… Typically, CVS or Walgreens will swoop in and purchase the Rx files and try to move all the pts to their nearby pharmacy. After “they” clear the community of independent pharmacies… if this particular chain store is not making as much profit as they expect or chain average, they will just shut it down and the community will be without any pharmacy to fill their Rxs.
Depending on the area, the next closest pharmacy may be 20-50 miles away. Not the chain or PBM’s problem, they will just encourage the pts to patronize their mail order pharmacy. If the pt needs a new Rx for acute problem.. the pt will just have to figure out how to get to a pharmacy XX miles away.
12 Kansas City area CVS locations close as pharmacists walk out over working conditions
https://amp.kansascity.com/news/business/article279648674.html
A CVS pharmacy in New York in November 2022. Several Kansas City area CVS locations have closed when pharmacists staged a walkout.
Twelve Kansas City area CVS locations unexpectedly closed Thursday and Friday because the pharmacists in charge there staged an organized walkout, calling in sick to protest recent corporate decisions.
One pharmacist — who spoke to The Star on the condition of anonymity because, they said, speaking to the media without permission results in automatic termination at CVS — said the walkout was the result of steadily declining working conditions.
Most of the affected locations locally are inside Target stores.
Among the grievances:
▪ CVS has cut the number of working hours per week a pharmacist can have a technician (a pharmacist’s assistant) on hand. “We are open 64 hours a week, and I’m only allowed help for 20 of those hours,” the pharmacist said. “That means for 44 hours out of the week, the pharmacist is working entirely alone — filling prescriptions, answering phone calls, talking to doctors, waiting on walk-ups. It’s like running a McDonald’s with just one person.”
▪ CVS has cut pharmacy hours at several Target locations. “I used to be open Monday through Friday, 9 a.m. to 7 p.m., Saturday 9 a.m. to 5 p.m. and Sunday 11 a.m. to 5 p.m.,” the pharmacist said. “Now, we’re open Monday through Friday, 10 a.m. to 6 p.m., and closed on the weekends.”
▪ Because the stores inside Target typically perform better than stand-alone “core” stores, the pharmacist said, a regional manager recently mandated that Target pharmacists be reassigned to core CVS locations to improve service there. “They’re having a harder time staffing the core locations because working conditions are so bad there,” the pharmacist said. “They (CVS management) think that because our locations have been more successful, we should be reassigned to help fix the core locations. Our district leader refused to implement that and was fired on Tuesday.”
Amy Thibault, a spokesperson for CVS, told The Star on Friday: “A small number of CVS Pharmacy locations in the Kansas City area are closed today due to unexpected staffing issues. We’re making adjustments and plan to reopen as soon as possible. In the meantime, patients with immediate prescription needs can visit any open CVS Pharmacy for assistance.”
The pharmacist said CVS’ decisions are putting patients at risk.
“They keep stretching us thinner and thinner,” the pharmacist said. “I regularly work 10-hour days and don’t have time to pee or eat lunch. When you are expected to work like that, there are going to be mistakes. At some point, a pharmacist is going to lose their license or get sued or a patient will lose their life because somebody didn’t check for allergies or interactions, and it will be because of these policies.”
A second CVS pharmacist who spoke to The Star on the condition of anonymity, again for fear of losing their job, said in an email that CVS uses an “arbitrary algorithm” to determine how many technician hours each pharmacy deserves per week. “We are a healthcare facility and we need to be able to provide healthcare, but we absolutely can’t under these conditions,” they said.
Three pharmacists went back to work Friday, the first pharmacist said, out of concern for patients waiting on their prescriptions.
The CVS inside the Target at 12200 Blue Valley Parkway in Overland Park was closed Friday “due to circumstances beyond our control,” according to its automated phone line. The same was true at the CVS in the Target at 1850 N.W. Chipman Road in Lee’s Summit.
A stand-alone CVS store — 9521 Mission Road in Overland Park — was also closed Friday.
The pharmacist said those who had walked out had not heard anything back from management.
“It’s been two days now and nobody has reached out to us to ask why or how they can help,” the pharmacist said. “You’d think they’d have questions, but not so far. We’re not asking for more money. We’re just asking for simple human decency.”
Filed under: General Problems
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