OPIOIDS: THE FALSE EPIDEMIC BASED ON DR. DAVID TAUBEN, MD AND CDC, PROP BIG LIE THAT SENT YOUR INNOCENT DOCTORS TO PRISON

DR. DAVID TAUBEN, MD

 

CDC (OPIOIDS), PROP “THE EPIDEMIC THAT WASN’T,” AND THE DEADLY RECORD OF DR. DAVID TAUBEN, MD “THE HIDDEN AGENDA OF PROP’S EUGENICS”

 

fund raiser for Emmalyn’s Journey

The little lady in the video below is just 14 y/o and has been thru 54 different surgical procedures since she has been born. That is 3-4 surgical procedure EVERY YEAR.

She is dealing with a handful of different health issues, each can be substantial pain generators,  Chiari Malformation, EDS, Adhesive Arachnoiditis, Tethered Cord Syndrome, Syringomyelia, Mast Cell Activation Syndrome, CSF leaks and lives with 10/10 pain in her head and back everyday. She also walks with a cane as she can’t bare weight on her left leg without it giving out.

Emmalyn’s neurosurgeon has recommended that she go to the Spero Clinic in Arkansas. After so many surgeries, her central nervous system needs to be reset, working in getting her walking again and hopefully getting her pain somewhat better! They will not be taking any pain meds away! Unless she is doing better. This is a very aggressive program to help with all of the above.

Emmalyn is on Arkansas’ Medicaid and Medicaid has so many hoops and hurdles to get them to approve paying for her to be seen by the Spero Clinic, and the clinic program is 3+ intensive months. They have so many slots, because they have pts dealing with rare/complex diseases coming to them, from all over the world.

American Pain and Disability Foundation was able to help raise the $2,500 down payment. To reserve her a slot in the first quarter of 2024. But she needs another $55,000 to pay upfront to be able to receive her needed therapy at Spero clinic, and the cost for the family because they will have to move to Arkansas while she is in therapy.

I remember when I was 14 y/0, a Freshman year in High School. Getting to enjoy football & basketball games, sock hops, and many other new kids in my universe, some I will become friends with. A few years later would get to go to Jr/Sr Prom and all the activities in between.  The Spero clinic may be Emmalyn’s best shot to her day to day life closer to what her teenage years should be like. Maybe she can walk away from her cane, walker and wheelchair and get along with her life.

Please consider donating https://www.gofundme.com/f/emmalyns-journey and sharing to help us reach her goal. Thank you for your kindness and support.

#EmmalynsJourney

https://emmalyns-journey.com/

 

 

 

 

 

 

 

 

 

 

https://www.gofundme.com/f/emmalyns-journey

 

 

 

In the rear view mirror: 10 Years Ago Today: My First Publication as a Pain Patient Advocate in the New York Post mirror:10 Years Ago Today: My First Publication as a Pain Patient Advocate in the New York Post

10 Years Ago Today: My First Publication as a Pain Patient Advocate in the New York Post

https://www.acsh.org/news/2023/11/30/10-years-ago-today-my-first-publication-pain-patient-advocate-new-york-post-17358

Exactly 10 years ago -December 2, 2013 – my first-ever published opinion piece about the erosion of pain control appeared in The New York Post. It was titled “New painful casualties of the drug war” and was written three years before the CDC’s formal declaration of war on pain patients. It is frightening to look back a decade and see how much of this has come true. Plus much worse. Here is the article from the Post opinion page.

Thanks to a thoroughly misguided move by federal drug bureaucrats, many Americans are going to have to live with needless pain.

In an ill-conceived effort to address narcotic abuse, the Food and Drug Administration has come up with a plan that will hit hard at people genuinely in need of pain relief. And ironically, it may very well make the drug abuse problem worse, not better.

The new regulations will raise hydrocodone (the narcotic found in Vicodin) from a Schedule III drug to Schedule II — the most restrictive category for any approved drug. As a result (among many other restrictions), doctors will no longer be able to phone a pharmacy to prescribe even a small emergency supply of any narcotic — the only effective medication for moderate-to-severe pain. (Non-narcotic pain relievers — the next available option — don’t even touch severe pain.)

Instead, the patient will have to physically get the prescription and bring it to the drugstore. Which will not be especially wonderful when it’s 3 a.m., the Vicodin prescribed after your oral surgery has run out, and your only choice is a night of extreme suffering or a trip to the ER.

The change will bring several short-and long-term consequences — all bad:

– The impact on people suffering from serious pain will be profound, especially for people living with severe, chronic pain, such as cancer patients who, if undertreated, will suffer enormously and needlessly.

– The shift effectively turns all doctors into potential suspects as drug pushers, so many will become more reluctant to write legitimate prescriptions for narcotics for fear of getting on a list — and you better believe there’ll be one.

– Drug abusers will get their fixes one way or another. If they can’t get Vicodin, they’ll find something worse.

That’s exactly what happened with OxyContin, a high-dose, time-release version of oxycodone (the narcotic in Percocet).

“Oxy” became a very popular drug of abuse since it contains 8 to 16 times the amount of oxycodone found in one Percocet. Addicts found out that they could get around the time-release properties by simply grinding up the pill, thus getting the entire dose at once.

So in 2010, Purdue Pharma, the makers of OxyContin, came up with an essentially foolproof formulation that prevented abuse. But a 2012 New England Journal of Medicine study examined subsequent narcotic use in drug-treatment centers in 39 states; it concluded that although Oxy abuse had dropped sharply, heroin use had doubled.

That didn’t work out all that well, did it?

Janet Woodcock of the FDA recently said, “These are very difficult trade-offs that our society has to make. The reason we approve these drugs is for people in pain. But we can’t ignore the epidemic on the other side.”

Maybe they can’t ignore it, but it should be none of their business. When medicine and law enforcement mix, everyone loses. It is not the job of doctors or the FDA to be involved in monitoring or addressing criminal activities.

It defies logic to create a policy that will effectively punish people who are in real need in order to short-circuit criminal activity. It’s just another self-defeating escalation in the dismal failure we call the War on Drugs.

Bad laws always have consequences. In this case, the “remedy” will be far worse than the problem — doing little or nothing to stop drug abuse but plenty to cause needless pain and suffering for people in need.

You don’t punish patients to go after addicts or criminals. That’s a pain our society should avoid.

Josh Bloom is the director of chemical and pharmaceutical sciences at the American Council on Science and Health.

Originally published in The New York Post

Is pain really all in your head?

 

I won’t drop down and say that this presenter suggests that your pain IS ALL IN YOUR HEAD. I am all in for complimentary care for the chronic pain pt. Often a full array of complimentary services many not be available/accessible, nor affordable by the pt.

Many pts are disabled and on Medicare disability and/or Medicaid. If the spouse is still around, the chronic pain pt, may not have transportation to medical services, because they no longer drive and spouse would have to take off work to transport them to get medical services/procedures. Causing the family’s finances to take “another hit”.

I noticed that “pain” seems to be addressed like it is like a monolith …  never talks about the intensity of the pt’s pain, nor the fact that the pt may have more than one disease/health issue that is a pain generator. I have communicated with too many chronic pain pts that state that their blood pressure has increased to emergency crisis level (200/100)+ after forced tapers and even when being prescribed 4-5 different pharma BP meds, their BP remains in the emergecy crisis level.

So it would appear that the pharma meds is focused on a different pathway than the pathway that under/untreated pain causes a pt’s BP to be elevated to a life threatening levels.

The chart below shows the potential of under/untreated pain complicating a pt’s co-morbidity issues and/or can cause the pt to have additional health/disease issues.

A pt being put thru forced titration of their opioids, may end up bed/chair/house confined. Much like being under house arrest without actually committing any crimes.

Shouldn’t all healthcare providers be focused on optimizing the pt’s QOL, with whatever services or products that the pt can afford?

Bob Sheerin was live with Stephanie Freeze

Bob Sheerin
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Help my girl Emmalyn!
This is the ornament that Emmalyn is making along with Kel’s creations with Kelli! These ornaments are part of her fundraising effort to get her to the spero clinic! With a $20 donation to her GoFundMe posted below you will receive an ornament. After your donation, please email me at sfreeze02@gmail.com with your address!! Thank you you all so much for always following and helping with Emmalyn’s Journey!!
www.GoFundMe.com/Emmalyns-Journey

SENATOR EDWARD J. MARKLEY (D) MASS., SIR, THE OPIOID EPIDEMIC IN AMERICA IS ONE MAGNIFICENT HOAX!!!

THE MISINFORMED AND MISGUIDED LETTER TO THE FDA OF SENATOR EDWARD J. MARKLEY (D) MASS., SIR, THE OPIOID EPIDEMIC IN AMERICA IS ONE MAGNIFICENT HOAX!!! “THIS CAN NOT CONTINUE” (2B version)

Bureaucrats are going to lower the cost of Rxs – without “fixing prices”

As you read this article remember that the top 5 PBMs or owned by the top five insurance companies. It is claimed that the PBMs get a very large chuck of their profits from demanding discounts/rebates/kickbacks from the pharmas to have their meds on the PBM’s approved formulary and no prior authorization required for a pt to get their Rx meds paid for. Reported those discount/rebates/kickbacks can total up to 75% of the medication’s AWP ( Average wholesale price).  So if a pharma needs to get $1.00/bottle more gross profit, they have to raise it by $4.00 because the PBM will snag $3.00 into their coffers.

Medicare has already set up some sort of “price negotiation” that is suppose to be active in another 1-2 yrs and now the states are setting up prescription drug affordability boards (PDABs), which usually set limits on how much some patients will have to pay for medications.

I get the impression that these bureaucrats really don’t know the hell what they are doing, but they are going to do it anyway.  I expect that pharmacy- especially independent pharmacies – will take the BIGGEST CUT in revenue, followed up by pts dealing with higher premiums and co-pays and lastly the insurance/PBM industry will figure out somehow to get little/no cuts in revenue.

“We” will probably see a dramatic increase in “pharmacy deserts”, as both independent and chain pharmacies become less profitable and or showing a loss. However, the insurance/PBM and the major chain pharmacies all have mail order pharmacies – that will try to take up the slack from the growing number of pharmacies deserts. Where typically it can take up to TEN DAYS for a pts to get their Rxs and those Rx meds can be exposed to ambient temperatures that exceeds what the FDA requires them to be kept in, but apparently none of the 50 state pharmacy boards give a damn about this.

States Making Progress Toward Setting Payment Limits for Some Drugs

https://www.medpagetoday.com/practicemanagement/reimbursement/107501

Prescription drug affordability boards are now the law in eight states

As drug prices continue to rise, some states are fighting back through the use of prescription drug affordability boards (PDABs), which usually set limits on how much some patients will have to pay for medications.

PDABs were the brainchild of Jennifer Reck and colleagues at the National Academy of State Health Policy (NASHP), which started working on the issue in 2016. “We were hearing from states that were really getting crushed by drug prices, and they needed the tools and resources to do something about them,” Reck, who is project director of NASHP’s Center for State Prescription Drug Pricing, said in a phone interview. “We convened a workgroup of state officials to dive into this topic, and the idea of a PDAB was one of the initial policy recommendations coming out of this.”

Using Rate-Setting as a Tool

The idea behind the PDAB was that “rate-setting is something that’s a common state activity, and looking to something like a public utility commission as an example, the state could create PDABs to review drug prices — not to set prices, which would be a violation of federal law — but instead to leverage the states’ rate-setting authority to set upper payment limits (UPLs),” she explained. Importantly, the UPLs apply only to in-state transactions; anything broader would run afoul of the Commerce Clause in the U.S. Constitution, which bars one state from regulating what goes on in other states.

So far, eight states have implemented PDABs: Maryland, Maine, New Hampshire, Oregon, Ohio, Colorado, Washington, and Minnesota, according to Kate Sikora, MBA, associate principal at the consulting firm Avalere, in Washington D.C. Legislators in Michigan recently introduced a bill that would establish a PDAB in that state, she said in a phone interview.

Not surprisingly, each state’s PDAB varies in its authority, Sikora continued: in Maryland, any UPL would apply only to patients and payers in state-run health plans such as state employee plans and Medicaid, whereas in Colorado, the UPL generally applies to any plan governed by the state, including those in its state health insurance exchange.

In fact, the statutory language regarding to whom Colorado’s UPL applies “is quite broad,” Lila Cummings, the director of Colorado’s PDAB, said during an online interview at which a public relations person was present. “I think it just says ‘all purchasers.'” Health plans for Colorado’s self-insured companies — those governed by the federal Employee Retirement Income Security Act (ERISA) — have the option of participating in the UPL for their beneficiaries, but they are not required to, Cummings said.

There are other differences among states too, Sikora said; for example, not all states are setting upper payment limits. “In New Hampshire, the PDAB is just for making recommendations to the state on how to lower drug price costs.”

One interesting element of Minnesota’s PDAB law, Reck noted, relates to the drug price negotiation program that Medicare is currently implementing. “The statute says that when setting a UPL for drugs that are subject to the Medicare rule, the board shall set the UPL at the Medicare Maximum Fair Price,” she said. “They’re not necessarily limiting their work to the drugs that Medicare is negotiating, but they’re saying that if there’s an overlap, they will use that as the UPL.” Sikora agreed that “watching Minnesota will be interesting next year” and added, “I think probably other states will do similar things because it involves a lot less work for the state.”

Colorado’s Rapid Progress

Observers generally agree that the state furthest along on the PDAB path is Colorado; its PDAB was created through legislation passed by the state’s General Assembly in 2021. Gov. Jared Polis (D) “appointed the first five members to the board in September 2021,” and the board and staff spent about 18 months setting up the program, including appointing a 15-person advisory council — made up of various members of the drug supply chain, including manufacturers, wholesalers, patients, and providers — to give the board advice, Cummings said.

In August, the PDAB officially approved an inaugural list of five drugs to be subject to “affordability reviews” for possible UPLs: etanercept (Enbrel); elvitegravir/cobicistat/emtricitabine/tenofovir (Genvoya); secukinumab (Cosentyx); ustekinumab (Stelara); and elexacaftor/tezacaftor/ivacaftor (Trikafta). Some of the 14 criteria to be considered as part of the affordability review include:

  • Input from patients and caregivers
  • Health equity impact
  • Current wholesale acquisition cost and changes in that cost
  • Impact on safety net providers
  • Orphan drug status
  • Input from individuals with scientific or medical training
  • Patient copays and other cost-sharing information
  • Price effect on consumer access
  • Rebates, discounts, and price concessions

The first review draft is expected out in a couple of weeks, Cummings said.

Why is Colorado so far along? Kate Harris, chief deputy commissioner for life and health policy at the Colorado Division of Insurance, attributes the relatively rapid pace to the requirements of the law. “We implement the statute the legislature passed with the timelines they passed it in, and where there is flexibility, we work at the pace of the board,” she said during the online interview that also included Cummings.

Hope Stonner, policy manager at the Colorado Consumer Health Initiative, a consumer group, seemed pleased with the PDAB’s progress. “What we’ve seen with the board is really encouraging,” said Stonner, whose organization helped get the law passed. “They have had to build this complicated entity from scratch, and it has been very encouraging to see the communal effort and the amount of public input the board has been receptive to.”

Maryland Also Moving Along

Maryland is another state that’s considered to be making good progress. “Our PDAB was created in 2019; it’s an independent agency with five members who are supported by a 26-member stakeholder council that represents different groups on the supply chain,” said Andrew York, PharmD, JD, executive director of the Maryland PDAB, during a phone interview. “The main work we do is cost reviews and setting UPLs.” York said he wouldn’t be surprised to see three to five drugs in the board’s first round of cost reviews, with the first set of reviews starting in the beginning of 2024 and finishing up by mid-year.

PDABs can learn a few things from the Medicare drug price negotiation program, York said. “The entire purpose of the Inflation Reduction Act [which included the Medicare price negotiation program] seems to be to save money because they are required to select qualifying drugs based on their highest overall spend, which is a very good idea. However, what PDABs can do is bring more nuance to the conversation, because they can consider other factors.” Although the list of drugs that have, for example, abused their market exclusivity may be similar for states as well as Medicare, “PDABs have the flexibility to look at additional drugs and try to be more nuanced in their assessments,” he said.

One of the Maryland PDAB’s members is Stephen Rockower, MD, a retired orthopedic surgeon from Bethesda, Maryland. “One of the things that drives physicians nuts is prescribing a medication and then having patients come back a month later or 2 months later and saying they didn’t take it because they couldn’t afford it,” Rockower, former president of MedChi, the Maryland State Medical Society, said in a phone interview. “We are in this business to take care of people, and if there are barriers that prevent them from doing the things that we asked them to do, then we’ve got to work to try to lower the barriers.”

The PDAB’s work also will affect physicians “because some of our physicians are actually dispensing medicines as well, like the rheumatologist who dispenses anti-inflammatory drugs” in their office, Rockower said. But even though setting a UPL may reduce the amount physicians can bill for the drugs they dispense, he said he didn’t think they would be adversely affected because their acquisition cost would also likely drop.

“I think what would happen is if the upper payment limit is set at a certain spot for … the patient, the price that the manufacturers or the PBM [pharmacy benefit manager] set will similarly go down,” he said. “So the physician who is sort of acting as a pharmacist, so to speak, will not get hurt by that.”

Cancer Patient’s Final Act: Destroying Medical Debt

Cancer Patient’s Final Act: Destroying Medical Debt

https://www.medpagetoday.com/special-reports/features/107497

Viral campaign will erase some $60 million in medical debt

A 38-year-old woman who died from ovarian cancer earlier this month posthumously launched a viral campaign that will help pay off an estimated $60 million in medical debt.

Casey McIntyre died on November 12, and in a thread posted to Xopens in a new tab or window (formerly Twitter) 2 days later, she wrote, “to celebrate my life, I’ve arranged to buy up others’ medical debt and then destroy the debt.”

“I am so lucky to have had access to the best medical care at [Memorial Sloan Kettering Cancer Center] and am keenly aware that so many in our country don’t have access to good care,” she wrote.

The post has garnered nearly 5 million views, and it links out to her campaign on RIP Medical Debtopens in a new tab or window, which has raised nearly $610,000.

RIP Medical Debt, which was formed by former debt collection executives, buys medical debt at lower prices and then forgives it, instead of collecting on it.

Allison Sesso, president and CEO of RIP Medical Debt, explained that the amount raised actually goes 100 times further in eliminating debt. For instance, a $10 donation erases $1,000 in medical debt — so McIntyre’s campaign will actually erase about $60 million in debt at this point.

Sesso said the McIntyre campaign began with a $20,000 goal, but that has been raised several times and now sits at $650,000.

“We’ve never seen a campaign raise so much money for medical debt abolishment so quickly,” Sesso said, adding that McIntyre’s campaign alone “will help tens of thousands of people.” Its debt erasure will focus on the Northeast region, where McIntyre’s family lives.

RIP Medical Debt was founded in 2014, and it has since erased $10.4 billion in medical debt for more than 7 million patients. Sesso said McIntyre’s campaign is the organization’s first posthumous fundraiser.

“It’s both heartbreaking and inspiring that nearing the end of her life, Casey, and her husband Andrew, had the vision and goodwill to think of others who can’t afford their medical care or who are buried under healthcare debts they’ll never be able to pay,” Sesso said. “I think that selflessness is really resonating with the public.”

McIntyre’s husband, Andrew Rose Gregory, told the New York Timesopens in a new tab or window that the family is “overwhelmed, and it’s been really powerful to see the response to people wanting to eliminate strangers’ medical debt.” Gregory also told the Washington Postopens in a new tab or window that McIntyre was fortunate to not have medical debt, but she had met plenty of fellow cancer patients who were not as lucky.

“People are making miserable decisions about their care because of money,” Gregory told the Post. “This imaginary debt is dragging so many people down. It’s an immoral part of our nation.”

McIntyre’s family posted in the thread on X that they would be hosting a “memorial service and debt jubilee” — inspired by anthropologist David Graeber’s book “Debt” — in McIntyre’s honor next month.

WARNING TO ALL KNOW HFPP!!! DOJ-DEA AND QLARANT MANIPULATED DATA TO EXTORT LARGE FINES FROM DRUG COMPANIES TO CHARGE AND ARREST ALL PROVIDERS FOR HEALTHCARE FRAUD, A CAMPAIGN OF INTIMIDATION!!!

” Qlarant Health Integrity (NBI Medic) advertises that they use specialized data analysis, which helps law enforcement locate buried targets and “speed conviction,”

LETTER TO CBS 60 MINUTES: AI GATE SCANDAL, NEARLY ALL U.S. GOV., MEDICAL DATA-ANALYTICS SHOWN FRAUDULENT, CAUSING THOUSANDS OF NEEDLESS DEATHS/SUFFERING; DOCTORS CALL FOR HELP!!!!

Foot Locker, Teamsters Show Their Drug-Benefit Managers the Door

Foot Locker, Teamsters Show Their Drug-Benefit Managers the Door

https://www.wsj.com/health/healthcare/foot-locker-teamsters-drop-pharmacy-benefit-managers-7251c81a

Employers and unions say the PBMs are favoring costlier drugs over less expensive options and aren’t open about their rebates

Employers and unions are getting fed up with the firms they have used for years to help control their spending on prescription drugs—because their costs keep soaring.

Footwear retailer Foot Locker dropped UnitedHealth Group’s OptumRx drug-benefit manager last year, while a Teamsters fund in Philadelphia recently reupped with its replacement for CVS Health’s Caremark.

Among their frustrations: They are being told to cover costlier drugs even when less-expensive options are available.

The employers and unions express concern that they are getting stuck with higher-cost drugs because the drug-benefit managers can pocket some of the bigger rebates negotiated with the medicines’ makers. The employers and unions say they can’t know for sure because the drug-benefit managers aren’t open about their fees and other sources of revenue.

After Alabama fabric maker Phifer replaced its drug-benefit manager, Prime Therapeutics, the new firm got rid of some expensive drugs—such as the nerve-pain medicine Gralise, which has a list price of $1,532 for one month’s supply compared with $13 for the generic equivalent.

Phifer’s new drug-cost middleman, known as a PBM for pharmacy-benefit manager, also substituted a generic migraine pill costing 80 cents a dose for a powdered brand called Cambia that lists for $118.26 per treatment.

“Do the games ever end?” said Russell DuBose, Phifer’s vice president of human resources. Under the new PBM, Phifer’s drug spending has dropped 18% to date this year.

Caremark, OptumRx and Cigna Group

’s Express Scripts—the largest of the middlemen—said they save their customers money and give employers information and options to tailor drug benefits to best suit their workers’ needs.

Big drug-benefit managers also said they win a lot of repeat business, which OptumRx said indicates customers like their choices and the information they get on their spending. Prime Therapeutics declined to comment.

The frustrations of some employers and unions are starting to shake up the important but under-the-radar sector for controlling spending on retail prescription drugs, which the Centers for Medicare and Medicaid Services projects will reach $411.6 billion this year.

PBMs last year handled virtually all of what amounts to 6.4 billion 30-day prescriptions, according to the research firm Drug Channels Institute.

To keep a lid on costs, the firms negotiate with drugmakers over how much each prescription will cost and then pass along the rebates they win. The PBMs can threaten to exclude a drug from the menu, or formulary, of medicines a health plan will cover if they don’t get a sufficient rebate.

Yet retail drug spending under private insurance has increased 3% each year, on average, for the last decade, according to CMS.

“What’s wrong with this market? Everything,” said Michael Thompson, chief executive of the National Alliance of Healthcare Purchaser Coalitions, which represents employers, unions and other organizations buying private health plans.

Jonathan Levitt, a healthcare lawyer at the firm Frier Levitt, said one of his employer clients settled an arbitration case with a PBM over how much information it should provide about the rebates it negotiates and another is now in a similar arbitration with a PBM.

Foot Locker replaced OptumRx last year because it wanted more information about how much the PBM was profiting off its work for the retailer, said Linda Gulbrandsen, Foot Locker’s vice president of North American benefits.

“We know our vendors work hard. We expect them to make money. But we expect to know every penny that they are making off of our team members,” she said.

OptumRx said Foot Locker’s contract had been negotiated through a group working on behalf of several customers. Companies that contract with OptumRx directly can have more flexibility in setting terms.

Foot Locker hired a smaller pharmacy benefit manager, Navitus Health Solutions of Madison, Wis., which tells employers it passes through to them 100% of the drug rebates it negotiates.

Navitus also does more to prioritize the use of low-cost prescriptions, Gulbrandsen said. Employees who need pricey drugs can get them, but are asked to first try cheaper options, when it is appropriate, she said.

Roughly 8,500 workers and their families enrolled in Foot Locker’s health plan. During the first year after the switch, spending on drugs dropped 5%.

Phifer left Prime Therapeutics, which works with many Blue Cross and Blue Shield health plans, at the end of 2022 because its costs were rising 7% a year and Prime wasn’t offering new solutions for controlling the increases.

“It was wash, rinse, repeat of the prior year,” DuBose said.

Phifer hired MedOne Pharmacy Benefit Solutions, which promotes the “different path” it takes from traditional PBMs. Founded by an Iowa pharmacy chain owner in 1999, MedOne, of Dubuque, Iowa, now counts more than 400 clients.

Because of the money it has saved on drug spending, Phifer was able to hold its premiums for 2024 flat, DuBose said.

SHARE YOUR THOUGHTS

What is your outlook for pharmacy-benefit managers? Join the conversation below.

The Teamsters Health and Welfare Trust Fund of Philadelphia and Vicinity, which replaced Caremark with venture capital-backed Capital Rx in 2019, recently renewed its contract with the upstart middleman because it has saved the fund more on drug spending each year than the fund projected, including 17% the first year.

Capital Rx also agreed to pass through all the rebates it negotiates, said Maria Scheeler, executive director for the Teamsters fund, which provides drug benefits to 16,000 people. “Best decision ever,” she said.

CVS said it has earned the long-term trust of employers, unions and others by being transparent, working to lower drug costs and offering options for health plans that meet the needs of the customers.