How private equity rolled Red Lobster

Back in the 1960s, there was this guy – Albert J. Dunlap https://en.wikipedia.org/wiki/Albert_J._Dunlap who was known at the peak of his career as a professional turnaround management specialist and downsizer.

He was known by the nickname “Chainsaw Al”. He would break up a company and sell off “parts”, because the parts were worth more than the company was a whole.

Just do a web search on “private equity acquisitions in the healthcare sector”  Below is a paragraph from an online article about private equity acquiring office practices and hospitals. Private equity companies are probably the worst part of our capitalist markets.

It would appear that the pt is just considered a conduit to move money from the pt’s insurance company to their bottom line. Maybe the pt gets the best care and outcome for the least amount of money that can be spent on pt care.

Unfortunately, those pts who tend to be “passive” – don’t speak up and/or advocate for themselves may be at risk for some of the worst-case health outcomes.

https://sph.brown.edu/news/2024-02-14/private-equity-health-care  The healthcare sector is witnessing a significant transformation as private equity (PE) firms step up their acquisition of physician practices. This trend reflects a broader shift within the healthcare industry of corporate investors acquiring healthcare providers, driven by the allure of short-term profitability and efficiency gains. It also raises questions about the implications for healthcare quality, accessibility, and the overall impact on the U.S. healthcare system.

Image: bankruptcy protection red lobster

https://www.nbcnews.com/news/amp/rcna153397

Angry that your favorite Red Lobster closed down? Wall Street wizardry had a lot to do with it.

Red Lobster was America’s largest casual dining operation, serving 64 million customers a year in almost 600 locations across 44 states and Canada. Its May 19 bankruptcy filing and closing of almost 100 locations across the country has devastated its legion of fans and 36,000 workers. The chain is iconic enough to be featured in a Beyoncé song.

Assigning blame for company failures is tricky. But some analysts say the root of Red Lobster’s woes was not the endless shrimp promotions that some have blamed. Yes, the company lost $11 million from the shrimp escapade, its bankruptcy filing shows, and suffered from inflation and higher labor costs. But a bigger culprit in the company’s problems is a financing technique favored by a powerful force in the financial industry known as private equity.

The technique, colloquially known as asset-stripping, has been a part of retail chain failures such as Sears, Mervyn’s and ShopKo as well as bankruptcies involving hospital and nursing home operations like Steward Healthcare and Manor Care. All had been owned by private equity.Asset-stripping occurs when an owner or investor in a company sells off some of its assets, taking the benefits for itself and hobbling the company. This practice is favored among some private-equity firms that buy companies, load them with debt to finance the purchases and hope to sell them at a profit in a few years to someone else. A common form of asset-stripping is known as a sale/leaseback and involves selling a company’s real estate; this type of transaction hobbled Red Lobster.

In recent years, private-equity firms have invested heavily in all areas of industry, including retailers, restaurants, media and health care. Some 12 million workers are employed by private equity-backed firms, or 7% of the workforce. Companies bought out and indebted by private equity go bankrupt 10 times more often than companies not purchased by these firms, academic research shows. In a report this month, Moody’s Ratings said leveraged buyouts like those pursued by many private-equity firms drive corporate defaults higher and reduce the amounts investors recover when the companies are restructured.

The sale/leaseback that helped sink Red Lobster involved the July 2014 sale of premium real estate underneath 500 of its stores, which generated $1.5 billion. But that money didn’t go back into Red Lobster; it went instead to the private-equity firm to finance its purchase of the chain, Red Lobster’s press release said. That firm was San Francisco-based Golden Gate Capital, with $10 billion in assets.Golden Gate had paid $2.1 billion to buy Red Lobster in May 2014, so the real estate sale was crucial to the firm’s financing. “Red Lobster is an exceptionally strong brand with an unparalleled market position in seafood casual dining,” Josh Olshansky, managing director at Golden Gate, said at the time, a press release announcing the deal shows.

The $1.5 billion sale crippled Red Lobster. After the real estate was sold, Red Lobster had to pay rent on stores it had previously owned, significantly increasing its costs. According to the bankruptcy filing, by 2023 its rents totaled $200 million a year or approximately 10% of its revenues.

Asked about the negative impact the sale/leaseback had on Red Lobster, a Golden Gate spokeswoman declined to comment.

The company that bought the properties, American Realty Capital Partners, got a very good deal, the press release announcing the sale/leaseback said. It characterized the Red Lobster stores it had purchased as “irreplaceable locations” and “high-quality real estate located at main intersections in strong markets,” but noted the properties were sold “at below replacement cost.” Under the terms of the sale, Red Lobster would also see regular rent increases of 2% a year, the release noted.

American Realty Capital Partners was acquired by Realty Income in 2021. Realty Income did not respond to a request for comment on the sale/leaseback.

The sale of the Red Lobster stores hurt the company several ways. First, it meant the chain would not benefit from any upside in the commercial real estate market. In addition, the new owner of the real estate did not appear to give Red Lobster good deals on rents. As Red Lobster’s CEO noted in a bankruptcy court filing, “A material portion of the Company’s leases are priced above market rates.”

As is typical in private-equity buyouts, Golden Gate’s purchase of Red Lobster significantly increased the chain’s debt, adding higher interest costs to its burden. In 2017, Moody’s Ratings, an independent ratings agency, downgraded Red Lobster to a negative outlook from stable. Moody’s cited the chain’s “persistently high leverage,” or debt.

“Carrying a lot of debt and not owning your real estate puts companies at a disadvantage,” said Andrew Park, senior policy analyst at Americans for Financial Reform, a nonprofit and nonpartisan organization advocating for a stable and ethical financial system. “Red Lobster is yet another example of that private-equity playbook of harming restaurants and retailers in the long run.”

In 2020, Golden Gate exited its Red Lobster investment, selling to Thai Union Group, a Bangkok-based company, and an investor group. Thai Union calls itself the “world’s seafood leader” and its brands include Chicken of the Sea tuna products and King Oscar sardines. Terms of the transaction were not disclosed.

Regarding the bankruptcy, a company spokesman provided a statement saying, “Thai Union has a been a supplier to Red Lobster for more than 30 years, and we intend for that relationship to continue. We are confident that a court-supervised process will allow Red Lobster to restructure its financial obligations and realize its long-term potential in a more favorable operating environment.”

Bankruptcies of companies like Red Lobster have a multiplier effect on the overall economy and contribute to a sense of unease among consumers and workers, said Robert Reich, a former labor secretary under President Bill Clinton.“One of the reasons people feel so insecure is you’ve got in the background, behind the curtain, a lot of these financial games that ultimately are making the very rich richer, and hurting America’s working and middle class,” Reich said in an interview. “All of the people who were supplying Red Lobster, all of the people who are essentially providing services to Red Lobster, the small businesses in the communities affected by mass layoffs, they are next in line, they are experiencing the ripple effect.”

Red Lobster’s employees are bearing the brunt of the collapse. Austin Hurst is one, a former grill master at a Red Lobster in Arizona. In an interview, he said he learned from a friend his store had closed and has not heard from his manager or any higher-ups at the company. He said he was told his store had been profitable until about 3 months ago.

“About a month before the close, the district manager came in and was like, ‘Yeah, this Red Lobster is looking really bright. And you guys are going to stay open for sure,’” Hurst recalled. 

Hurst said he was offered a job at another Red Lobster location but it requires a longer commute and pays $17 an hour, down from the $19 he was making before.

Sen. Edward Markey, a Democrat from Massachusetts, where eight hospitals operated by bankrupt Steward Health Care are, recently held hearings on private equity and health care. He has also proposed legislation that would require greater transparency from health care entities owned by private-equity firms, including the disclosure of sale/leaseback arrangements as well as fees collected by the private-equity firm, and dividends paid by the health care entity to the private-equity fund.“My legislation is quite simple,” Markey said in an interview. “To make sure that these financial shenanigans don’t have a profound impact upon communities across our country, the Department of Health and Human Services has to determine whether or not the sale of the land underneath these hospitals and then having that land rented back to the hospitals isn’t having a negative impact on the provision of health care in that community.”

Private equity is emerging in all parts of our economy, Markey added, but its most profound impact is in health care. “The more private equity gets into the hospital business,” he said, “the more this is just a preview of coming atrocities affecting our health care system.”

Optum ditching facilities and staff to protect bottom line?

Optum is a PBM, the FDA and many state legislatures are looking into how the PBM industry functions financially and Pres Biden is claiming that he is going to lower Rx prices. Is this how Optum is trying to get a head start on any impact that all of these things could do to protect their bottom line? Closing a 93,000 sq ft facility – that is about 1.5 times the size of your average Walmart store.  The second article states that RN case managers are being laid off. Are these part of the process dealing with prior authorizations? Does this mean that more PAs will be denied and/or take longer to get one approved?

Optum laying off 129, closing Ohio facility

https://www.beckershospitalreview.com/finance/optum-laying-off-129-closing-ohio-facility.html

Optum is closing a Change Healthcare facility in Toledo, Ohio, resulting in the termination of 129 employees located in Ohio or working remotely.

The layoffs will occur in three waves from July 15 to Sept. 6, according to regulatory documents filed with the state on May 16. The 93,000-square-foot facility is located at 100 North Byrne Road in Toledo.

In April, former employees with Optum and its subsidiaries took to social media regarding a reduction in force they say occurred across the company. Optum declined to provide more information about the layoffs at the time, and it is unclear if they are connected to the Toledo layoffs.

Optum also laid off an unknown number of employees in August. Affected facilities included the Everett (Wash.) Clinic and the Polyclinic in Seattle; Morgantown, W.Va.-based MedExpress Urgent Care; and San Antonio-based WellMed.

Here is a earlier article concerning these layoffs

Optum enacts layoffs, workers say

https://www.beckershospitalreview.com/workforce/optum-enacts-layoffs-workers-say.html

Former employees with UnitedHealth Group’s Optum and its subsidiaries took to social media beginning April 18 regarding a reduction in force they say occurred across the company.

Optum declined to provide more information April 19. Becker’s has not confirmed an exact number or range of employees who may have been terminated or when layoffs would be effective.

Across LinkedIn, former employees with Optum and affiliated providers have detailed layoffs enacted at their organizations. A range of roles appear to have been affected, from RN case managers to senior director and management positions.

In 2023, many large insurers conducted large workforce reductions due to financial or operational challenges in certain segments, along with restructuring strategies. 

Optum also laid off an unknown number of employees in August. Affected facilities included the Everett (Wash.) Clinic and the Polyclinic in Seattle; Morgantown, W.Va.-based MedExpress Urgent Care; and San Antonio-based WellMed.

UnitedHealth is still recovering from the cyberattack on Change Healthcare in February — the company had reinstated 80% of the functionality for its claims, payment and pharmacy services as of April 16.

UnitedHealth Group posted a $1.4 billion net loss in the first quarter of 2024, primarily due to the sale of its Brazil operations, along with the cyberattack. Despite the losses, the company beat investor expectations.

How we could cut the illegal opioid drug poisoning

I know that it would be crazy to expect our Federal Gov to address this crisis with a business mindset.  Go after the crisis like Walmart or Amazon gets rid of competitors, sell stuff FOR LESS!

Addiction is never going to go away. It is claimed that alcohol causes 100,000/yr deaths, but only about 1% of the deaths are from alcohol toxicity BAL >0.4. One percent is 1,000/yr OD from alcohol. This is probably because alcoholic know the “strength” of their drug of choice and know what their limit is.

The Feds seize how many tons of illegal Fentanyl?  Hire a pharma to test, to make sure that it is only Fentanyl. Take the seized Fentanyl and create standardized- unique tablets- with several strengths- and sell them at the Feds net cost. Undercut the street merchants and the Mex cartels.  Maybe put the bottles of these opioids in vending machines in highly visible locations to help prevent vandalism. This way, chronic pain pts could get adequate therapy and addicts can get their “fix” and hopefully fewer would OD/poisoned.

Was George Orwell a futurist and we are seeing it now 40 yrs later?

Protesters gather to speak out against pharmacy benefit managers

https://fox2now.com/news/contact-2/protesters-gather-to-speak-out-against-pharmacy-benefit-managers/

ST. LOUIS – Dozens of protestors are making sure they were seen and heard Friday morning outside Express Scripts in north St. Louis County. 

They say pharmacy benefit managers, like Express Scripts, are manipulating drug prices, steering patients to their own mail and retail pharmacies and creating obstacles for patient access. Park Hills, Mo., resident Loretta Boesing organized the event.

“The fight will continue until we get justice, until we get protection as patients, until there’s justice for every pharmacy that’s closed due to their monopolistic practices,” Boesing said.

FOX 2 first met Boesing in 2018 after her family was forced by insurance to switch to a mail-order pharmacy. Her son’s medication was poorly packaged and damaged in the heat. The dose sent him into liver rejection, and he was lucky to survive. The experience spurred her activism.

“We need more protection. We need the FTC and our legislators to do more,” she said.

Local independent pharmacy owner Jerry Callhan took part in the protest. Since 2019, we’ve chronicled his growing criticism of pharmacy benefit managers, the impact on his patients and his business.

“People need to understand how they’re getting shafted by the PBM industry” Callahan said.

Friday’s protest had national reach. Himanshu Patel owns an independent pharmacy in Chattanooga, Tenn.

“It’s about life and death for me. It’s either come here and fight or stop working as a pharmacist and do something else,” Patel said.

Doug Hoey is CEO of the National Community Pharmacists Association.

“There’s legislation that’s been passed in the house, but we need the senate to take it up. And there’s also legislation that would help with Medicare, which is a third of the business of the average pharmacy,” he said.

Missouri Democrat Lucas Kunce, who attended the protest, says he’d fight for it if elected to the U.S. Senate.

“We need to use the Federal Trade Commission, the Department of Justice, we need to use all the tools at our disposal to just enforce the monopoly laws we have, break these guys up and protect us from their predatory actions,” Kunce said.

Express Scripts gave FOX 2 the following statement:

“The health of our customers is at the center of all we do. We work relentlessly to ensure our customers can access their medications at the lowest possible cost and in the way that is most convenient for them. Our flexible pharmacy networks include pharmacies of all scales and sizes, including large chains, regional and independent pharmacies, as well as home delivery options.”

Express Scripts

“We hadn’t had something that brought us all together and united us against these corporations. That is my goal here today. This is just the start. This is only the beginning,” Boesing said.

GA Governor Kemp veto bill to prevent PBM from paying indy pharmacies less than chains get paid

On ‘This Week in Pharmacy’ we’re blowing the doors off the story in Georgia how Owners of independent pharmacies are criticizing Governor Brian Kemp’s decision this week to veto legislation aimed at rectifying a situation that has left them at a competitive disadvantage with pharmacy chains. We’re also talking about Identification Technolgies driven by A.I., by Alitheon, with a huge impact to the world of counterfeit medications. Independent Pharmacy Owners in Georgia take another blow to the face as their businesses and PublicHealth Services to their communities are threatened by the latest decisions on Senate Bill 198. Owners of independent pharmacies in Georgia are criticizing Gov. Office of Governor Brian P. Kemp ’s decision this week to veto legislation aimed at rectifying a situation that has left them at a competitive disadvantage with pharmacy chains. Senate Bill 198, which the state House and Senate passed with only one “no” vote, would have required the State Health Benefit Plan (SHBP) covering teachers and state employees to reimburse independent pharmacies filling prescriptions at rates no less than the average reimbursement provided to chain pharmacies. Full article here: https://lnkd.in/epQsshEB This is State Representative Buddy Carter’s home state and as a pharmacy owner, I am sure he’s in disagreement with this decision which will exacerbate the problems our Georgia State Independent pharmacies are facing, causing many to face financial problems and some pharmacies will be forced to close. To add to this story, PPN was informed that the President of the Georgia Pharmacy Association Mr. Joe Ed Holt was fired from PruittHealth for publicly disagreeing with the decisions of Georgia State Governor Kemp vetoing SB198 which makes reimbursement for Independent Community Pharmacies unfair compared to mail order and chains?? “Fraudulent and unidentified goods infiltrate nearly every industry, damaging businesses, economies and livelihoods, as well as risking public health and safety,” said Roei Ganzarski, CEO of Alitheon. “TIME’s recognition of FeaturePrint as a leading invention puts this growing problem in the spotlight, where it should be.” Alitheon’s FeaturePrint enables you to trace and authenticate any individual items wherever they go and along the way, including medications. On the assembly line or in the marketplace, track and trace the one in the millions and know with certainty, that they are not being swapped, changed, or faked along the way.

Pharmacies sharing medical records without warrants

A shocking revelation by Congress is calling into question Americans’ right to privacy about their health, and if private medical data can be used criminally against you. In a letter to the Department of Health and Human Services, lawmakers share their concerns over how the nation’s largest pharmacy chains handle requests for records from law enforcement, which do not require a warrant. Healthcare attorney Harry Nelson breaks down what is happening. #Health #Pharmacies #medicalrecords “NewsNation Now” is a no fluff, no filler newscast hosted by Nichole Berlie and Connell McShane featuring up-to-the-minute news drawing from a network of journalists across the U.S. Weekdays starting at 1p/12C. NewsNation is your source for fact-based, unbiased news for all America. More from NewsNation: https://www.newsnationnow.com/ Get our app: https://trib.al/TBXgYpp Find us on cable: https://trib.al/YDOpGyG How to watch on TV or streaming: https://trib.al/Vu0Ikij

Lobbyists for PBMs come to a legislature bringing LIES and $$$ for re-election campaign funding

https://www.wjfw.com/news/it-has-everything-to-do-with-politics-and-money-and-had-nothing-to-do-with/article_65021442-0f0b-11ef-8231-7fc629d78536.html

Pharmacy benefit managers or PBMs for short, now wield nearly limitless power and influence over the prescription drug market owning at least 85% of pharmaceutical industry. Their tight grip on the market has allowed them to engage in unfair pricing practices with very little oversight. They can raise the price you and your insurance company pay for medications, and instead of passing that revenue along to pharmacies, they keep it for themselves. Without having to answer to anyone, they rake in the cash off consumers backs and hurt patients in the process.

Which leaves the question, what is being done about it and how are they not being regulated? Well, let’s dive in …shall we.

A bill was presented at the state level during last session to demand PBM reform, unfortunately it didn’t even get called to vote.

“Why it didn’t get voted upon is something that will anger me forever, because it has everything to do with politics and money and had nothing to do with the right thing,” said Dan Strause former CEO of Hometown Pharmacy. 

Wisconsin Representative Micheal Schraa, shares some insight.

“The general public has no clue. I spoke at a Republican Lincoln day dinner about three weeks ago. And I said how many people in this room, and there were about 140 people, how many in this room know what a PBM is, pharmacy benefit manager, six hands went up,” said Schraa. 

Yet the negative Impact PBMs have on the nation’s healthcare system is growing daily. As more and more small pharmacies are getting smothered out of the equation.

Schraa said his drive to push PBM Reform legislation started about 10 years go when his pharmacist Ken brought it to his attention.

“I walked in one day and Ken just said, you got to sit down with me, and I got to tell you what’s going on. Were getting killed by these things, by these PBMs, and I’m like what’s a PBM, I never heard of it before,” said Schraa. 

Micheal said he started doing his own research and asking questions, the more he learned the more eye opening it was to him. That something needed to be done.

“There we a lot of powerful statements and a powerful testimony from people that had personal experiences with how the PBMs have negatively affected them. So, it’s just been my mission. I knew I would be coming again this session with another bill. Senator Felzkowski and I worked on it and it was really frustrating at the end, not having it go anywhere.

Bill 737 had 104 co-sponsors on it out of 132 legislators. Schraa personally went to every single democrat and republican office in efforts to get as much bipartisan support on the bill as possible.  But it never even got called to the floor to be voted upon during the last legislative session. There were 13 separate asks in the bill and there were even efforts made to amend a single one of these asks into a separate bill, pertaining to hospitals, that would demand some transparency from PBMs regarding formularies. (Called MAC Pricing Language which is a spread showing the average cost of a drug across all companies that manufacture that drug.) In hopes that it would be the most beneficial piece to independent pharmacies.

“So, we had this amendment and we added it to another bill that the hospitals really needed. We felt this was a bill that couldn’t be killed and wasn’t going to have an issue in the Senate,” said Schraa. 

“The Mac language was kind of watered down a little bit, but we still got a chunk of it in there. I thought this is great. The governor’s office was in they didn’t like a little bit of wording so we changed it to appease them so they would sign the bill, or sign the bill that this amendment went to, and we passed it. And it went over the senate and died,” said Schraa. 

There are many speculations as to why the PBM reform bill, has been avoided.

“The ugly part of politics is that campaigns cost a lot of money to run and not everybody can self-finance especially in the assembly or the senate,” said Schraa. 

However, Schraa said there are still those willing to fight for the people and what’s right.

“That’s where the heart of this issue comes in. There’s 30-some other states that have passed pretty significant PBM reform. The decision makers in those states have made a decision, we’re going to stand up for the people,” said Schraa.

Schraa has a plan for the next legislative session to break down this complex bill and get it passed.

“It’s a complicated issue,” said Schraa. Unless you’re a pharmacist or someone who works with this everyday it can be really hard to focus on the several different things this bill highlights. Schraa plans to break it down to have a legislator for each section.

“That way I think the health plans and PBMs that are against this, its going to be a lot harder for them to come in and trash 12 or 13 different legislators. They were going around lobbying in each office saying, you know Schraa’s PBM bill is going to raise prescription drug costs, out right lying,” said Schraa. 

Schraa said he understand lobbyists and their job is to protect their clients.

“There’s so much money in this game for them and they’re so powerful and the lobbying core is so well paid,” said Schraa.

Schraa said it’s frustrating because he sees the net effect that PBMs are having on so many people including his own family, who have fallen victim to adverse medical reactions due to wrongful practices. Schraa said, he and fellow supporters will continue to bang their fists on the desk until PBM reform is accomplished.

“The education process is huge, and I think this patient protector will be a game changer. It’s going to be super hard for them to continue to shovel this underneath the table and try to hide it. When you have so many different avenues bringing the light out and exposing, you know light is the best disinfected and that’s starting to happen,” said Schraa.

That’s why patientprotector.us was created, if you or a loved one are being affected, share your stories on the online portal so they can be heard by legislators and a difference can be made. 

A Philadelphia pharmacy’s closure after 26 years highlights the industry’s growing challenges

A Philadelphia pharmacy’s closure after 26 years highlights the industry’s growing challenges

https://www.dailyitem.com/wire/business/a-philadelphia-pharmacy-s-closure-after-26-years-highlights-the-industry-s-growing-challenges/article_156e7cfc-4a50-522d-b99a-2212bb3b1f92.amp.html

Last Monday, Friendly Pharmacy filled 318 prescriptions. For about 100 of them, insurance companies paid the pharmacy less than $3.

In 22 instances that day, the reimbursement was less than the cost of the medication. And that’s just among the prescriptions that were actually filled. Managing pharmacist Brad Tabaac said he has to turn away some patients because their prescriptions will cause too much of a loss for his business.

One recent patient, for instance, came in hoping to transfer his inhaler prescription to Friendly after his local Rite Aid closed. Filling the medication would have cost Friendly $22 more than the insurance reimbursement.

“I just can’t afford to serve him,” Tabaac said.

And now he can no longer afford to serve anyone.

Tabaac plans to close his doors on May 31 after 26 years in business. As a second-generation pharmacist, he said, he’s been working in drug stores since he was 11 years old. Making money on medicine wasn’t a question back then, but now it’s a string of “exhausting” calculations on a daily basis.

“Years ago, you would just fill prescriptions, and you would concentrate on patient care,” Tabaac said. “Now you have to look at each and every prescription you fill and say, ‘Am I losing money?’”

Why pharmacy benefit managers are challenging small pharmacies

Independent pharmacies like Friendly, as well as some chains, have been pinched by pricing and fees set by pharmacy benefit managers — the companies that handle prescription drug plans for health insurance.

The three biggest pharmacy benefit managers are CVS Health, Optum Rx and Express Scripts. They control nearly 90% of the market, according to the National Community Pharmacists Association (NCPA), and some of their parent companies also own pharmacies. In other words, NCPA has said, “what community pharmacies charge patients and are reimbursed is often determined by a competitor.”

This challenge has caused more than 80 community pharmacies in Pennsylvania to close just in 2024, said Rob Frankil, executive director of the Philadelphia Association of Retail Druggists (PARD). Contracts with pharmacy benefit managers are “take it or leave it,” he said, giving individual business owners little to no room for negotiating reimbursement rates that will allow them to stay in business.

PARD has been lobbying lawmakers for changes.

The Federal Trade Commission is conducting an inquiry into the system. Chair Lina M. Khan said at a White House Roundtable in March that complaints to the commission suggest pharmacy benefit managers “hike the price of drugs, deprive patients of access to certain medicines, and drive community pharmacies out of business.”

As pharmacy benefit managers “have consolidated and vertically integrated, we hear of a system where corporate red tape and bureaucracy obstruct patients from getting their medications, sometimes with devastating results,” Khan said.

Khan noted that the pharmacy benefit managers haven’t fully complied with FTC orders seeking documents and data.

“We are undertaking this work with enormous urgency and focus. And if we find evidence of illegal practices, we will not hesitate to act,” Khan said.

Tabaac acknowledges that effort but said it’s coming too late for his business.

“Pharmacists knew they were going to lose money on branded drugs,” he said. “But they were signing these contracts because they were thinking, ‘What else am I going to do?’”

Other costs rising

While Tabaac can’t control the revenue he brings in from prescriptions, despite having plenty of customers, he also can’t control certain costs that have risen in recent years. One of them is business insurance, he said, which has become more expensive in part due to his pharmacy’s location in the Kensington neighborhood. Friendly was dropped by its business insurer in recent years because of incidences of vandalism in the community, he said, and had to find a new policy.

“The insurance companies do not want to insure us,” Tabaac said. “We’re too much of a risk.”

Once Friendly closes, the closest chain pharmacy is a Rite Aid about three-quarters of a mile away. A few other independents remain open closer to Friendly’s location, according to city records, but pharmacy density here is lower than in other sections of the city.

Not long ago, Tabaac absorbed the patients from another independent pharmacy nearby that closed because of finances.

Tabaac is concerned about the patients who have accessed prescriptions through Friendly’s delivery services or relationships with doctors who do house calls, as well as those who don’t drive and will have to take public transit to a new location.

“Will they find an advocate? Some of them will,” he said. “I fear that many of them won’t.”

FDA issues ‘most serious type of recall’ for insulin pump-related iOS app

FDA issues ‘most serious type of recall’ for insulin pump-related iOS app

https://www.msn.com/en-us/health/other/fda-issues-most-serious-type-of-recall-for-insulin-pump-related-ios-app/ar-BB1mg98J

The U.S. Food and Drug Administration has issued a Class I “most serious type of recall” for an iOS app used in conjunction with an insulin pump.

The “correction” as referred to by the FDA on Wednesday, rather than a product removal, relates to the t:connect Mobile App iOS v2.7. It was confirmed by Tandem Diabetes Care the following day, which stated that Android app users are not included in the recall.

“The t:connect mobile app works with the t:slim X2 insulin pump with Control-IQ technology,” the FDA states. The pump delivers insulin under the skin at set and variable rates for the management of diabetes. 

The app recall is due to a software issue that may cause the app to crash and be automatically relaunched which “may result in pump battery drain and may lead to the pump shutting down sooner than typically expected.”

The FDA says pump shutdown “could lead to an under-delivery of insulin and may result in hyperglycemia or even diabetic ketoacidosis, which can be a life-threatening condition due to high blood sugars and lack of insulin,” and encourages those with diabetes who use insulin pumps to carry backup supplies in case of pump failure.

“The correction highlighted in the recall notice was addressed in the t:connect app update for the Apple iOS platform (v2.7.1) released on March 18th,” Tandem Diabetes Care said in a press release. “Affected customers were notified by Tandem on March 26th, and more than 98% of affected customers had already updated their devices as of April 15th. We continue to make every effort to contact everyone who has not yet updated their iOS app to the new version.”

Tandem Diabetes Care gives detailed instructions to customers who wish to check their mobile app versions here. 

“Ensuring the safety of our patients is our top priority, and we take any safety concerns with our products very seriously,” Tandem Diabetes Care said in its release. “No deaths have been reported, and we will continue monitoring the new version of the t:connect app released in March to ensure the concerns described in the recent recall notice from the FDA have been addressed.”