What the Hell !!! Sorry to post so soon but Mr. Mayer has made me just a little mad.(Drug Topics Final Word February 2012) How dare he suggest Walgreen's CEO get the Remington medal. Has he lost his freaking mind! Let's review.
Walgreen's takes a stand on ESI because they are not paying them enough money. They don't pay the rest of us enough money. I would love to tell ESI to kiss my butt but I don't have wall street giving me butt loads of cash to keep my store open, nor do I have crap from China on my shelf to sell to my customers at 300% percent profit to help keep my doors open. Did I forget to mention that I get about 5% percent of sales off my front end while Walgreen's gets about 70%. Hey Mr. Mayer, did you forget how Walgreen's got it's growth spurt? See one of my first articles about prohibition.
Let's look at your earlier statement in your article shall we. Quote "in 1962, when I opened my pharmacy in Sausalito, Calif., there were 59 independent pharmacies that took care of Marin County, Calif., patients. Now there are 4 independent pharmacies left, partially due to the 3 managed care companies like ESI, who have squeezed the small businesses out of existence." Well Mr. Mayer, how many FREAKING WALGREEN'S and CVS's are in MARIN COUNTY !!! Get real... These guys (chain pharmacies) have advantages over all independents. It's called WALL STREET INVESTORS. I would love to have people give me free money. (Mr. Mayer doesn't even mention what chains have done to independents over the years and their mail order facilities). Did he mention that Walgreen's has doubled their efforts to expand their mail order facilities and their central fill facilities? no? well la tee da... do some research...if you really are president of a consumer advocacy group do some advocating for a change instead of just placating....
Now for some sobering stuff...
If Walgreen's stock suffers...from NOT taking ESI, or from ESI refusing to allow Walgreen's to participate (can you say Rx Ally anyone) then you will see the board of Walgreen's replace management very rapidly. It happens everyday. That is Wall Street reality.
So Mr. Mayer, I agree with you that pharmacists should do what that are trained to do AND get paid for it. HOWEVER ( I know I am shouting, it's the best way to be heard) being stupid and praising Walgreen's isn't the proper way to do it. Just calling the kettle black.
Kris
Thursday, March 8, 2012
Tuesday, March 6, 2012
What PBMs Do
Kudos to Mr. Evan Vickers! Mr. Vickers is a member of the Utah House of Representatives and a pharmacist. In the February edition of Drug Store News he tells it like it is. PBMs provide almost no value to our economy, no value to health care and almost no value to the consumer. I will quote a few memorable passages "PBMs profit at the expense of consumers. These are for-profit companies that function as intermediaries between health plans,drug companies, retail pharmacies and patients. Their motive is PROFIT, NOT PATIENT CARE. The three largest PBMs, including ESI and Medco, have seen their profits nearly quadruple in the last three years-from $900 MILLION to more than $3.5 BILLION- while most Americans have struggled through a tough recession."
Doesn't this just make you sick to your stomach. If you are involved in health care at the provider level at all, you have to be sick to think of how much money is being wasted on corporate fat cats. McKessions CEOs salary equated to about 25 thousand dollars for each independent pharmacy that does business with them. Isn't that a kick in the pants. As small business people we are constantly being asked to help our local communities and our patients (who are unemployed and broke). We are being asked for more and more dollars from our associations and co-ops to fund activities to fight these abuses. I don't have a problem with this as long as there is accountability and transparency. We need to make sure our leaders are transparent and accountable just like we want the PBMs to be. I will give you 50 bucks to give to a congressman but you had better make sure he votes for our bills. We need to make sure that people whom we give money vote to help independent pharmacy.
On another note, Dr. Dan Hussar, from the Pharmacist Activist, wrote that CVS should have criminal charges filed against them for their activities involving oxycodone in Florida. CVS obtained an injunction to prevent the DEA from shuttering two of their stores in Florida that dispensed many many scripts of oxycodone while two independents were closed. Thanks Dan for exposing what CVS is doing and also Cardinal. Wholesalers are also not exempt from that almighty dollar. Don't get me wrong, if you are breaking the law, you need to go to jail. That means independent, CVS and yes, Cardinal. Maybe it's time the CEO of CVS and Cardinal were dragged out of their penthouses in handcuffs for allowing their locations to break the law over and over again. I know that I would be on the 6 o'clock news being put in the squad car if it was my store. Why not them? Oh, that's right, money...
Hey, you guys heard any more about RxAlly? No, read the first paragraph again and substitute RxAlly for PBM and see if it makes sense.
Lastly, thanks to the brave independents in North Carolina. You guys are our heros!! For those of you who haven't heard, there are four independents in North Carolina who are suing CMS for allowing restricted networks and differential co pays. I wish you the best of luck and we need to support them with our dollars. This is what matters. Get your co-op and association to get behind them and support them. It is about time someone stood up for what is right. Thank you !!!!
Til next time.
Kris
Doesn't this just make you sick to your stomach. If you are involved in health care at the provider level at all, you have to be sick to think of how much money is being wasted on corporate fat cats. McKessions CEOs salary equated to about 25 thousand dollars for each independent pharmacy that does business with them. Isn't that a kick in the pants. As small business people we are constantly being asked to help our local communities and our patients (who are unemployed and broke). We are being asked for more and more dollars from our associations and co-ops to fund activities to fight these abuses. I don't have a problem with this as long as there is accountability and transparency. We need to make sure our leaders are transparent and accountable just like we want the PBMs to be. I will give you 50 bucks to give to a congressman but you had better make sure he votes for our bills. We need to make sure that people whom we give money vote to help independent pharmacy.
On another note, Dr. Dan Hussar, from the Pharmacist Activist, wrote that CVS should have criminal charges filed against them for their activities involving oxycodone in Florida. CVS obtained an injunction to prevent the DEA from shuttering two of their stores in Florida that dispensed many many scripts of oxycodone while two independents were closed. Thanks Dan for exposing what CVS is doing and also Cardinal. Wholesalers are also not exempt from that almighty dollar. Don't get me wrong, if you are breaking the law, you need to go to jail. That means independent, CVS and yes, Cardinal. Maybe it's time the CEO of CVS and Cardinal were dragged out of their penthouses in handcuffs for allowing their locations to break the law over and over again. I know that I would be on the 6 o'clock news being put in the squad car if it was my store. Why not them? Oh, that's right, money...
Hey, you guys heard any more about RxAlly? No, read the first paragraph again and substitute RxAlly for PBM and see if it makes sense.
Lastly, thanks to the brave independents in North Carolina. You guys are our heros!! For those of you who haven't heard, there are four independents in North Carolina who are suing CMS for allowing restricted networks and differential co pays. I wish you the best of luck and we need to support them with our dollars. This is what matters. Get your co-op and association to get behind them and support them. It is about time someone stood up for what is right. Thank you !!!!
Til next time.
Kris
Saturday, February 25, 2012
Bulls in Texas and The Beatles
This week in Florida there was a man named Loeffler from a big company called HEB that made a bold statement. He said and I quote "In Texas they say that if it looks like bull crap, and it feels like bull crap, and it smells like bull crap, then it probably is genuine grade A pure bull crap". Kudos to Mr. Loeffler for making that statement about the ExpressScrips/Medco merger. He also said that Medco chairman and CEO David Snow is in line for a 39 million golden parachute. Quote "now who does it look like has been using the lack of transparency to shovel big money their own way as opposed to driving health care costs lower?" BTW Mr. Loeffler is chairman of NACDS. Pretty bold. Thanks Mr. Loeffler for calling that particular kettle black.
On another note this week I received a nice fax from my friendly pharmacy co-op asking me to join the "revolution" (yes, using lots of quotation marks today). What's this you say. The new RxAlly revolution. There was a link so I proceeded to watch a 45 minute press conference and I must say at the end of presentation I was just as confused as in the beginning. Here's the skinny. The RxAlly CEO is Bruce Roberts. Remember him, former NCPA CEO who took credit for starting such things as SureScripts and Mirixa. Well he's back and has partnered up with our dear neighbor down the street; Walgreens. RxAlly is a for-profit company that not only has Walgreens as an owner but our very own co-ops. See if you recognize yours: Academy of Independent Pharmacy of Georgia (AIP), American Associated Pharmacies (AAP), American Pharmacies (APRx), American Pharmacy Cooperative, Inc. (APCI), Carolina Allied Pharmaceutical Services (CAPS), Chain Drug Consortium (CDC-lots of non stock market chains), EPIC pharmacies (EPIC), Independent Pharmacy Cooperative (IPC), PBA health (PBA), and Pharmacy Providers of Oklahoma (PPOK). Whew, what a mouthful. Let's discuss this new alliance.
RxAlly claims to have 20 thousand member stores. In reality they have the CEO's of the various groups and their boards. NOT their members. I understand per RxAlly's website that each store must sign up (or was it each pharmacist?) so that tells me they have nothing in the way of a network so far. I understand the concept but let's be transparent here. What is the purpose of RxAlly? Wait, here it is. Quote "Help patients achieve better health through personalized pharmacist care while reducing costs." Great concept..Why did RxAlly go with pharmacy buying groups as partners in order to provide these services. You would think they would have gone with more professional groups say like: APhA (American Pharmacists Association), NCPA (National Community Pharmacist's Association), ASHP (American Society of Hospital Pharmacists), ACA (American Colleges of Apothecaries), AACP (American Colleges of Pharmacy) or NASPA (National Association of State Pharmacy Associations). I didn't see any of these folks during the press conference. All I heard was the 280 billion dollar waste (and the 20 year old Ashville study) and how PHARMACISTS could help lower this cost to EMPLOYERS... How does a co-op or Walgreens (who are profit driven) even begin to be above board in bringing savings to patients. Greg Wasson, CEO of Walgreens said it was about the PROFESSION of pharmacy and changing the landscape. Ok, cool, but why do you need a drugstore for that change? Why couldn't pharmacist's provide that service from home or on their off days? I wonder how many people involved in this start up has EVER provided a clinical service. It looked to me that there were a bunch of white headed CEO's in the room who I bet haven't worked the pharmacy counter since Nixon was president. One thing I didn't hear a lot about during the press conference was how pharmacy was going to be paid for performing these services. Still a mystery. I wonder how many pharmacists will make up the board for RxAlly? I bet there will be a few but probably most will be CEO's and MBA's. There may not be a single independent pharmacy owner on that board. (I bet not). Just a ramble or two more.
It seems to me that Walgreen's (being shut out of ESI and soon Medco) is looking for a way to shore up it's losses so that big Wall Street investors will continue to funnel money to them.(they just bought BioScripts, a big mail order speciality pharmacy) They have a great game plan. Let's look at how independent pharmacy survives and copy that! (and still keep our mail order and central fill facilities and our buying power) Wow, and now let's form a company so we can learn from them first hand; (remember who Bruce Robert's used to work for?) and to get their buying groups on board as well.(why didn't the co-ops do this on their own, who needs Walgreens) This being said I would ask Mr. Wasson why the rest of the profession wasn't at the table? If it's about moving the profession then let's get the profession to embrace change. The RxAlly model is not new (maybe the Walgreen's part). Independent pharmacy has been taking care of patient needs forever. That's why most pharmacist's want to own their own store. So they can practice how THEY want and take care of folks how they want. Not how some MBA CEO tells them. Bruce Roberts says that "There is a need for greater access to health care for patients throughout the U.S." All patent's have access, just not everyone is willing to pay. Everyone wants lower cost but no one wants to pay for it. It also makes me mad as HE double hockey sticks that EVERYONE skirts the real reason we have such high health care costs in America. WE Subsidize the world!! If we paid for our drugs like other countries we could reduce pharmacy costs by billions. (and even pay our pharmacies more). If we regulated the manufacturers and middlemen (PBM's, TPA's etc) and taxed them appropriately we could save billions more. Our system is set up for making a few people rich (1%) and the rest of us paying the price(99%). We have multi billion dollar companies running rampant over small business and a congress that holds out it's hand and looks the other way. Tell us what you want us to hear and put that money in your pocket. I hope RxAlly achieves it's goal, but I will tell you I am sick and tired of working for free. I hate to think that a middleman (RxAlly) is going to negotiate with payers for my services and then tie my performance to a contract. When I perform a service for my patients they pay my price (outside of filling a prescription) and they are usually very happy with the outcome (everyone wins). I think that since about 100 percent of our prescriptions are dictated by PBM's, that other entities see pharmacist services as an area they can exploit (and make themselves rich in the process). You know this model has worked before. Are your Surescripts transactions free yet? Let me now quote the Beatles.
"You say you want a revolution, well you know, we'd all want to see the plan. You ask me for a contribution, well you know, we're all doing what we can. But if you want money for people with minds that hate, all I can tell you is brother you'll have to wait. Don't you know it's gonna be alright."
More on this subject later. I've got to clean out this stall. You know they have bull's in all 50 states.
Kris
On another note this week I received a nice fax from my friendly pharmacy co-op asking me to join the "revolution" (yes, using lots of quotation marks today). What's this you say. The new RxAlly revolution. There was a link so I proceeded to watch a 45 minute press conference and I must say at the end of presentation I was just as confused as in the beginning. Here's the skinny. The RxAlly CEO is Bruce Roberts. Remember him, former NCPA CEO who took credit for starting such things as SureScripts and Mirixa. Well he's back and has partnered up with our dear neighbor down the street; Walgreens. RxAlly is a for-profit company that not only has Walgreens as an owner but our very own co-ops. See if you recognize yours: Academy of Independent Pharmacy of Georgia (AIP), American Associated Pharmacies (AAP), American Pharmacies (APRx), American Pharmacy Cooperative, Inc. (APCI), Carolina Allied Pharmaceutical Services (CAPS), Chain Drug Consortium (CDC-lots of non stock market chains), EPIC pharmacies (EPIC), Independent Pharmacy Cooperative (IPC), PBA health (PBA), and Pharmacy Providers of Oklahoma (PPOK). Whew, what a mouthful. Let's discuss this new alliance.
RxAlly claims to have 20 thousand member stores. In reality they have the CEO's of the various groups and their boards. NOT their members. I understand per RxAlly's website that each store must sign up (or was it each pharmacist?) so that tells me they have nothing in the way of a network so far. I understand the concept but let's be transparent here. What is the purpose of RxAlly? Wait, here it is. Quote "Help patients achieve better health through personalized pharmacist care while reducing costs." Great concept..Why did RxAlly go with pharmacy buying groups as partners in order to provide these services. You would think they would have gone with more professional groups say like: APhA (American Pharmacists Association), NCPA (National Community Pharmacist's Association), ASHP (American Society of Hospital Pharmacists), ACA (American Colleges of Apothecaries), AACP (American Colleges of Pharmacy) or NASPA (National Association of State Pharmacy Associations). I didn't see any of these folks during the press conference. All I heard was the 280 billion dollar waste (and the 20 year old Ashville study) and how PHARMACISTS could help lower this cost to EMPLOYERS... How does a co-op or Walgreens (who are profit driven) even begin to be above board in bringing savings to patients. Greg Wasson, CEO of Walgreens said it was about the PROFESSION of pharmacy and changing the landscape. Ok, cool, but why do you need a drugstore for that change? Why couldn't pharmacist's provide that service from home or on their off days? I wonder how many people involved in this start up has EVER provided a clinical service. It looked to me that there were a bunch of white headed CEO's in the room who I bet haven't worked the pharmacy counter since Nixon was president. One thing I didn't hear a lot about during the press conference was how pharmacy was going to be paid for performing these services. Still a mystery. I wonder how many pharmacists will make up the board for RxAlly? I bet there will be a few but probably most will be CEO's and MBA's. There may not be a single independent pharmacy owner on that board. (I bet not). Just a ramble or two more.
It seems to me that Walgreen's (being shut out of ESI and soon Medco) is looking for a way to shore up it's losses so that big Wall Street investors will continue to funnel money to them.(they just bought BioScripts, a big mail order speciality pharmacy) They have a great game plan. Let's look at how independent pharmacy survives and copy that! (and still keep our mail order and central fill facilities and our buying power) Wow, and now let's form a company so we can learn from them first hand; (remember who Bruce Robert's used to work for?) and to get their buying groups on board as well.(why didn't the co-ops do this on their own, who needs Walgreens) This being said I would ask Mr. Wasson why the rest of the profession wasn't at the table? If it's about moving the profession then let's get the profession to embrace change. The RxAlly model is not new (maybe the Walgreen's part). Independent pharmacy has been taking care of patient needs forever. That's why most pharmacist's want to own their own store. So they can practice how THEY want and take care of folks how they want. Not how some MBA CEO tells them. Bruce Roberts says that "There is a need for greater access to health care for patients throughout the U.S." All patent's have access, just not everyone is willing to pay. Everyone wants lower cost but no one wants to pay for it. It also makes me mad as HE double hockey sticks that EVERYONE skirts the real reason we have such high health care costs in America. WE Subsidize the world!! If we paid for our drugs like other countries we could reduce pharmacy costs by billions. (and even pay our pharmacies more). If we regulated the manufacturers and middlemen (PBM's, TPA's etc) and taxed them appropriately we could save billions more. Our system is set up for making a few people rich (1%) and the rest of us paying the price(99%). We have multi billion dollar companies running rampant over small business and a congress that holds out it's hand and looks the other way. Tell us what you want us to hear and put that money in your pocket. I hope RxAlly achieves it's goal, but I will tell you I am sick and tired of working for free. I hate to think that a middleman (RxAlly) is going to negotiate with payers for my services and then tie my performance to a contract. When I perform a service for my patients they pay my price (outside of filling a prescription) and they are usually very happy with the outcome (everyone wins). I think that since about 100 percent of our prescriptions are dictated by PBM's, that other entities see pharmacist services as an area they can exploit (and make themselves rich in the process). You know this model has worked before. Are your Surescripts transactions free yet? Let me now quote the Beatles.
"You say you want a revolution, well you know, we'd all want to see the plan. You ask me for a contribution, well you know, we're all doing what we can. But if you want money for people with minds that hate, all I can tell you is brother you'll have to wait. Don't you know it's gonna be alright."
More on this subject later. I've got to clean out this stall. You know they have bull's in all 50 states.
Kris
Friday, January 13, 2012
The Amazing Spiderman and Fails To Care
Well, another year, another crappy start with insurance/PBM issues. How many new cards have you had to call about, and what about that D.0. It should have been called BO or better yet BS data requirements. I hope everyone had great holidays and enjoyed the seasons and now let's get to the new year. We all know the story of Peter Parker, the boy who was bitten by that spider, and overnight received amazing powers. In our independent industry today Spiderman is the Co-op. When co-ops first started out they were going to help us in purchasing generic drugs. Now they do everything from third party contracting, front end merchandising, loss prevention, auditing help and who knows what else. During this whole process where are we at with purchasing generics? Not much better than 20 years ago. None of our independent co-ops are big enough to leverage any generic company so most of them use one of our friendly neighborhood wholesalers to get the leverage. Nothing beats being the little guy with a 300lb defensive lineman behind you. When we fill scripts and get paid 8 bucks for 8 ounces of Hydromet from Caremark and that 8 ounces cost us 22 bucks where did our co-op benefit us? I say that every service a co-op provides benefit independent pharmacy, but someone needs to hammer these companies to get the lowest price on generic product. IF our co-ops are amazing (and most are) then why in the hell are they not working TOGETHER ! If every co-op joined together and put together a program to bid out generic product then we could get somewhere on the buy side. To do that, guess what, they need to get rid of the 300lb lineman, and that ain't easy. Especially when he helps you do all that other amazing stuff. I think it's about time our friends in the co-ops start working for US and find a way to work together to lower our costs of goods. Now let me say this. I hear that there is movement under foot for some of our co-ops to work with some of the big boy chains. If this happens I would ask, do you think that the big boys will give up their advantage to help us? Maybe so. All I know is I would rather have all the independent co-ops working together than a few working with one of the big chains. As for Fails To Care, don't you think the FTC is about as useless as a pig with wings. How in the world can they fail to see what harm this alliance has done to the public by the way they are restricting access and taking unfair market advantage of patient data. Now that this has been decided by the FTC you will see more restricted networks and use of patient data than ever before. I guess when every last independent pharmacy is closed maybe the feds will care. CVS/CM paid 5 million, I bet NCPA and other independent pharmacy groups spent over 50 million fighting this merger. So, what about ESI/Medco? I say, save your money. Fails To Care will approve it as well because the FTC could give a rat's whisker about small business. They never have and never will. If the republican candidates want to do away with a part of government that is worthless for small business then let's nominate the FTC. Listen, let your voice be heard. If you are tired of all this BS, let your co-op know, your association know, your congressman, even your mailman. If you don't like the way an audit turned out, go to the courthouse and sue them. Ask a jury of your peers if it's fair for a PBM to take back the cost of the drug when there are no laws broken. Stand up, get angry, make some noise. You don't need that lineman. If every Peter Parker stands together no one can stop them. Start standing.
Kris
Kris
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