White Paper Exposes Delay, Waste, and Cancer Treatment Obstacles Imposed on Patients by Pharmacy Benefit Managers

A new white paper released today by the Community Oncology Alliance (COA) and the Community Oncology Pharmacy Association (COPA) exposes the negative impact pharmacy benefit managers (PBMs) have on the care cancer patients receive.

Compiling real stories of cancer patients and physicians, the white paper “Delay, Waste, and Cancer Treatment Obstacles: The Real-Life Patient Impact of Pharmacy Benefit Managers (PBM)” was released today at the opening of the 2017 Community Oncology Conference.

Presenting true patient stories collected from community oncology practices over the last year, the white paper details common PBM practices that have a negative impact on cancer patient care. The serious, sometimes dangerous, stories told in the paper include the delay of treatment for as much as six weeks, unaccountable PBM bureaucracies, unethical business practices, and incredible waste.

Read the story here


SHAREHOLDER ALERT: Goldberg Law PC Announces an Investigation of Express Scripts Holding Company

Goldberg Law PC, a national shareholder rights litigation firm, announces that it is investigating claims on behalf of investors of Express Scripts Holding Company (“Express Scripts” or the “Company”) (ESRX).

If you purchased or otherwise acquired Express Scripts shares and would like more information regarding the investigation, we encourage you to contact Michael Goldberg or Brian Schall, of Goldberg Law PC, 1999 Avenue of the Stars Suite 1100, Los Angeles, CA 90067, at 800-977-7401, to discuss your rights without cost to you. You can also reach us through the firm’s website at http://www.Goldberglawpc.com, or by email at info@goldberglawpc.com.

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Clawbacks: Hidden Costs Of Copay

DECATUR, Ill. (WAND) – When you use insurance to pay for a drug prescription there is a good chance you use a copay to pay part of the cost. But what you may not know there is often an unseen middleman increasing costs for you and your pharmacist.
The middleman is known as a Pharmacy Benefit Manager, or PBM. PBM’s negotiate drug prices between drug makers, insurance providers and pharmacies. The PBM impacts you and your neighborhood pharmacist in a couple of ways through two types of transactions known as clawbacks. Copay clawbacks and DIR fees. Let’s look at copay clawbacks first:

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One of the biggest middlemen in the drug industry is losing its largest customer — and the stock is tanking

Express Scripts, one of the largest pharmacy benefit managers in the drug industry, said on Monday that its largest customer will not renew its contract with the company. Shares of Express Scripts were down 15.45% as of 5:40 p.m. ET.

The customer, Anthem — owner of a variety of Blue Cross Blue Shield health insurance firms — is responsible for roughly 18% of Express Scripts’ first quarter revenue, Express Scripts said in a release.

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Bob Bryan and Lydia Ramsey


Transparency needed on companies that manage prescription drugs

If you’re like most Californians who have health insurance, you know two things about how prescription drugs fit into your health plan. You know that you receive some level of coverage for medications, and you know that soaring prices for prescription drugs are a major cost-driver that have caused insurance premiums to soar.
What you don’t know is how your coverage for prescription drugs works, who determines which drugs are covered, or who gets how much from the money you pay for your prescription drugs. The fact is, almost no one knows those things.

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Special to The Bee

The Sacramento Bee

Heartbreak as independent pharmacy closes in Warren County

The Warren County Pharmacy was never just that. To some, it was family.

Even on Thursday, a day after it ceased pharmacy operations, customers wandered in to pick among the increasingly bare shelves for home goods, greeting cards and other tchotchkes.

Some were upset, even tearful, when they learned the shop that has been there along Route 57 in Washington for more than 75 years will close its doors for good at the end of the month.

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By Steve Novak | For lehighvalleylive.com The Express-Times
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on March 16, 2017 at 3:10 PM, updated March 16, 2017 at 3:15 PM

STUDY: How TV News Ignores The Prescription Drug Price Problem

Opening a new front in the war against big pharma, Sen. Bernie Sanders (I-Vt.) and a slew of Democratic colleagues introduced a bill Tuesday to allow commercial importation of drugs from Canada.

The appeal is obvious; through cheap imported drugs, the United States would be able to take advantage of the government levers and regulation that other countries have used to bring down pharmaceutical prices. It’s a far more politically palatable way to attack the problem of soaring drug prices than opening up an even more contentious fight over whether the U.S. government should meddle directly in pricing — and it has had wide popular and bipartisan support, including from Hillary Clinton and Donald Trump during the presidential campaign.

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March 13, 2017 3:13 PM EDT ››› CAT DUFFY

Reform Pharmacy Benefit Managers (PBMs) To Improve Pharmaceutical Affordability

Imagine if you never had to directly pay for your morning cup of coffee again. Instead, a coffee insurer guaranteed that, for a small co-pay, you could enjoy a cup of coffee every morning.

Sounds good?

The catch, and there is always a catch, is the caveat “directly pay.” In this bizarre world, you would still be paying for your cup of coffee every morning, but instead of paying your favorite barista, you would now pay your local coffee insurer.

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Forbes.com Wayne Winegarden, Contributor

Gilead Executive Says Pharmacy Benefit Managers Keep Prices High

Gilead Sciences Inc.’s hepatitis C cure set off a firestorm of criticism over high drug prices in 2014 that hasn’t let up since. Now an executive says the company can’t cut the product’s price because middlemen who manage drug benefits would refuse to cover it.

“If we just lowered the cost of Sovaldi from $85,000 to $50,000, every payer would rip up our contract,” said Jim Meyers, executive vice president of worldwide commercial operations, in an interview with Bloomberg News.

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How ‘middlemen’ force some small-town pharmacists out of business

Your small town community pharmacists say they’re under threat from an unregulated industry which they believe limits the choices consumers have to buy their medicine. They the blame the problem on “middlemen” drug suppliers called pharmacy benefit managers (PBMs).

This year, Republican lawmakers in Georgia and Washington, D.C. are doing something unusual about it – asking for more regulation of the industry.

Mark Parris operated two pharmacies in Blue Ridge, Georgia for 19 years. He sold both in 2014 after he says about 30 percent of his patients were forced to get their medicine elsewhere.

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