Tuesday, March 13, 2018
Real change for state
The egregious actions of the pharmacy benefits managers (PBMs) in 2018 shined a spotlight on their dishonest business practices and revealed how little oversight these entities have. PBMs are the middlemen in your health care that decide what medication your insurance plan will pay for and what pharmacy you can use, and set the prices pharmacies are paid.
For example, when CVS/Caremark sets the prices of locally owned pharmacies, it pays them $60 per prescription less than it pays its own pharmacies. CVS sets its competitors' prices while sending out letters to these same competitors offering to buy pharmacies that were struggling due to CVS/Caremark's actions. This type of activity is deceitful, anti-competitive and simply wrong.
CVS/Caremark's actions related to prescriptions for opioid medications were even more unconscionable. While communities are tackling prescription drug abuse, CVS/Caremark was profiting from pain by paying itself three times what it paid local Arkansas pharmacies for the same opioid medication.
But the most atrocious example uncovered was the medication Harvoni, which is used to cure Hepatitis C. CVS/Caremark paid a locally owned pharmacy $11,718 while it paid itself $31,657.95, almost $20,000 more than its competitor on one single prescription!
The good news is that our elected leaders are listening. Gov. Asa Hutchinson has called a special session to begin today to place much needed oversight on PBMs, Lt. Gov. Tim Griffin has acknowledged that the market isn't working, and Attorney General Leslie Rutledge has opened an investigation into the activities of CVS/Caremark. Legislative leaders like Sens. Ron Caldwell, Jason Rapert and Bruce Maloch, and Reps. Michelle Gray, Jeff Wardlaw, Reginald Murdock and Jimmy Gazaway and many others are leading the efforts to bring about real change for Arkansas.
Scott Pace is CEO of the Arkansas Pharmacists Association.
Williams has misfire
Walter Williams in his recent column makes two fundamental errors. First, he equates regulation of automobiles to the regulation of guns. The logic necessary to conflate the regulation of products designed to transport people with products designed to injure and kill is beyond credulity. The absurdity of the related logic comes even more into focus if it includes gun products whose only purpose is to increase the carnage available to the shooter (automatic rifles and banana clips).
The second mistake is almost as egregious. Professor Williams says, "Problems ... of antisocial behavior will continue until we regain our moral footing." In conjunction with his preceding comments in this column, he must mean that less gun regulation will somehow help us regain our moral footing. But maybe I am wrong in my inference of his causation. If so, could we at least have more gun regulation until we regain our moral footing, however we do it?
There are so many things to be outraged about these days that I have refrained from writing to this paper. I don't expect anything I say will have an effect on tax cuts for millionaires producing another explosion in the national debt, cuts in Medicare, or still more high-end state tax cuts. A local issue has arisen, however, where I have some questions.
My pharmacist told me recently about losing over $50 filling a prescription. From what the patient said, the insurance company claimed to have paid almost three times the wholesale cost of the drug, but CVS paid less than half that cost to the pharmacy. I cannot verify the numbers, nor do I know how a "pharmacy benefits manager" operates or what the role of Blue Cross Blue Shield is in this.
I do know there have been stories in this paper that expand on what I heard. A recent paper reported that CVS is paying its own stores more than it pays other pharmacies and inviting small pharmacies to sell out to it. Surely no company with retail outlets should be allowed to determine how competing outlets are paid, and taking over competitors is a classic monopoly tactic.
My wife and I got a surprise recently when we called our drug insurance company, and the person answering the phone said, "CVS/Caremark." Nothing we had seen identified the company as part of the CVS network.
The governor has agreed to deal with reported abuses by CVS in a special legislative session and seems to be thinking about additional regulations. That might be a good idea, but I think we also need a prosecutor to open an investigation. I'm no lawyer, but I think that what I am hearing requires a full public airing by someone with subpoena power.
Another big cat seen
I believe Sharon Williams saw a black panther, because I saw one about 35 years ago.
It was about 6:30 on a mid-April morning. I had finished my morning rounds at the hospital. Being too early to go to the office, I decided to drive over the completed, but not yet opened, Ouachita River Bridge and down the new four-lane highway.
About a half-mile down the highway, perched on the concrete median barricade, sat the largest black cat I ever saw. I stopped within 10 yards of the animal and watched it for a few minutes until it hopped off and slowly crossed the highway in front of me and down into the woods. From snout to the end of its tail it had to be eight to 10 feet long, and I would guess its weight to be close to 200 pounds.
I wrote the Game and Fish Commission and was told that there are no black panthers in Arkansas. I know there was at least one!
JUDSON N. HOUT
Editorial on 03/13/2018
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