Trustees from the North Carolina State Health Plan recently heard from Jessi Stout, pharmacist in charge at Table Rock Pharmacy (Morganton, N.C.), about the impact of PBM practices on beneficiaries, taxpayers and independent pharmacies. Specifically, the discussion was focused on CVS Caremark, the PBM administering the benefit for the state health plan. The board of trustees approved an examination and investigation of specific practices by CVS Caremark, including, but not limited to, differential reimbursements to different types of retail pharmacies; reimbursements below a pharmacy’s acquisition cost; and how CVS Caremark is able to contract with GoodRx/other PBMs to adjust prices. You can find more information here. CVS Caremark has been in the news recently for its expansion of programs to Kroger and Costco affiliates to push patients on maintenance drugs to a 90-day supply rather than three 30-day supplies. The idea, they claim, is to improve adherence—a strategy instigated by PBMs gradually over the last 10 years that’s been criticized for its basis in population-level assessments rather than the kind of individualized care that patients require. More of the same for this behemoth trying to strongarm everyone they can any time they wish.
NCPA
