Bil from Wisconsin is out asking for help.
He is from the asthma community.
He’s been helping with PBM reform stuff.
He’s helping the pharmacists.
I accidentally got their documentary pulled down off the internet. I feel bad about it. I was posting it everywhere because I never wanted to have to explain what a PBM was again. It took you all, like, 5 years to explain it to me. It sucks to explain.
One day, I saw UHG make a post on LinkedIn, and I wanted to post the documentary there. I paused because instinct told me that there might be trouble. But you get a lot of views on those big corporate posts. So, I waited. I thought about it. I waited until midnight to post it…in case they just deleted it right away - they do that. I figured they would not notice until morning.
It was worse than I thought. UHG made a bunch of defamation charges against those guys. The movie got pulled down off the internet. I felt even worse because they are in Wisconsin and I am in MN. I felt like I did something terrible to a neighbor. Other patient communities and diabetics and pharmacists work together on a lot of problem solving. Now, they are scared. So, if you want to give them a ‘like’ on youtube, that helps them.
They are asking for help on LI. #pbmreform #truth | Bil Schmidtknecht
They are asking for youtube ‘likes’ and ‘subscribes’ so they don’t get pulled down again by UHG when they release episode 2. https://www.youtube.com/watch?v=k0bcWlI4ht4 I’m worried there might be trouble, but there’s no way around it. There has to be freedom of speech. Discussion of these topics needs to happen among citizens.
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I think this highlights the problems with the pharmacies. They just want to make money and won’t do the things that their customers need; they do have a duty of care to customers but they are abnegating it for a pure but very temporary profit. To quote about the case:
Walgreens failed to provide him with a medically equivalent, affordable alternative or contact his doctor to amend the prescription.
Here’s what one pharmacy industry related organization says on the issue of what pharmacies can do:
This really is a job for the pharmacists. Yeah, I know I’ve spent the last few days campaigning for us to be proactive in our own choice of insurance, it’s that time of year, but we need the pharmacists to step out of their enormously profitable industry for a moment and see that if they kill all their customers they will be tomorrow’s COVID.
ATM they’re slackers.
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The argument can be made that there is a difference between a self employed, family run pharmacy and a pharmacy owned by private equity (Walgreens) or a large insurance company and PBM (CVS).
Consider the difference between a physician who owns his own practice and one who works for UHG.
They lose their autonomy & authority. Its the difference between owning something and being owned by something. The power dynamic changes. The PBMs suddenly achieved auditing power over small independent pharmacies that were their competitors. They could enact large fines on their smaller competitors as a result. They did. They do.
Scott is writing about the formularies today. He writes, " The simple reality is not as simple: insurance company drug “formulary-exclusions” of less costly generic products are widespread in the U.S. because legally-exempted rebate kickbacks (rebates) are paid to PBMs only contingent upon insurance company preferred drug formulary-exclusion of less costly generics, thereby hiding them from most Americans. First we need to fix the legally-exempted kickback problem.
The September 20, 2024 FTC litigation (still pending adjudication) against CVS Caremark, Cigna Express Scripts and United Healthcare’s Optum Rx for accepting kickbacks to block less costly NDCs for other products in a particular class of drugs, and the intended relief seeks to ban formulary-exclusion of lower-cost drugs and pricing schemes that artificially increase patient costs.
While work-arounds such as cash-pay options such as Mark Cuban Cost Plus Drug Company, PBC for generics (including telehealth prescriber options) exist, but real change will only emerge when we remove bribery from pharmaceutical commercialization in the U.S."
