Here is another article about CVS/Caremark padding their own pockets and paying their competitors “pennies” over what they were paying their own CVS pharmacies. The survey was on over 250 different common medications and when a state employee had a medication filled at at a CVS .. .the CVS store was paid a AVERAGE of $60 more for the same medication/strength/quantity.
https://www.pharmaciststeve.com/?p=25784
Ohio has found CVS/Caremark that handled all but one of their Medicaid/HMO programs were keeping/taking money that they were not entitled to.
W Virginia has dumped their unnamed PBM for their state Medicaid program and is saving TENS OF MILLIONS every year
South Dakota has managed their Medicaid prescriptions for years because the could do it at a lower cost that any PBM
KY is looking into what they are being charge by the PBM for their Medicaid system.
The PBM industry came to be in 1969-1970 and the average Rx price back then was $4 -$5 and today the after Rx price is in the low $70 range. In 1970, 95% of all Rxs were brand name and today 90%+ are now generics.
If we were still at 95% brand name and applying the CPI/COLA to the 1970 price it would suggest that the Rx price today would be in the mid $30 range… If one tries to adjust for today’s 90% generics that average could be in the $25 range..
The question is why is there nearly a $50 difference from what it is and what it should be ? The PBM industry now control the prices of abt 90% of all prescriptions filled and that – in and of itself – could be some of the answers.
But since the insurance industry is claimed to have one of the largest/deepest “pots of money” to pay for lobbyists… there is little question as to why these Rx price have increased and continue to increase at a rate above the CPI rate.
Filed under: General Problems
Not wanting to belabor the obvious, but the propaganda campaign aimed at drug distributors for supplying infependent drugstores with opioids, that was wisely trumpeted by CBS and the Washington Post, painted CVS Caremark as a responsible company supporting the Drug War. It woukd be interesting to learn how much CVS money went into promoting that self serving story and witch hunt.