Kevin Pelter, Pharm.D. @pelterkevin
Joined June 2023-
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Column from former pharmacist, state Sen. Dave Burke who now leads Ohio Pharmacists Association: PBMs drive drugs cost up, run Ohio pharmacies out of business. Upcoming hearing opportunity for Sen. Sherrod Brown to get answers. dispatch.com/story/opinion/…
Great article. This last segment sums it up nicely: “No one is coming to save you. If you think somebody needs to do something, it’s you” Keep posting. Keep sharing ideas. Keep challenging anyone who thinks community pharmacies aren’t vital to healthcare.
Great article. This last segment sums it up nicely: “No one is coming to save you. If you think somebody needs to do something, it’s you” Keep posting. Keep sharing ideas. Keep challenging anyone who thinks community pharmacies aren’t vital to healthcare. https://t.co/VA6RuA4hEn
Some prescription insurance claims that were automatically diverted to “discount cards” this week. I compared previous claims for these patients, most of the “discount card” claims had higher priced copays, yet insurances claim theses cards are to get you better prices vs ins.
I’ll gladly sell. My asking price is $50million. No low-ballers. I know what I have.
I’ll gladly sell. My asking price is $50million. No low-ballers. I know what I have.
Tell me again how the Big 3 PBMs negotiate with and support independent pharmacies. #Pharmacy #PBMabuse @JusticeATR @linakhanFTC @POTUS
Congress can swiftly vote to ban TikTok, but can’t seem to agree upon the fact that Pharmacy Benefit Managers are robbing everyone by the Billions every year behind a veil of secrecy. Won’t be long before every state in America will be coming for these greed stricken bastards.
Get your popcorn ready for this one 🍿 Can’t wait to hear what @UnitedHealthGrp has to say about how they’ve found yet another way to ruin healthcare and run physician practices into bankruptcy, then offer to buy them out. All stemming from a problem @UnitedHealthGrp created.
Get your popcorn ready for this one 🍿 Can’t wait to hear what @UnitedHealthGrp has to say about how they’ve found yet another way to ruin healthcare and run physician practices into bankruptcy, then offer to buy them out. All stemming from a problem @UnitedHealthGrp created.
Someone explain how @cvspharmacy was paid $150 more than my independent pharmacy for the same medication, on the same Medicare Drug plan just one month apart last year? By using @cvspharmacy, that extra $150 difference put this patient that much closer to the coverage gap.
Houston, we have a problem. And that problem is corporate greed and corruption. If @pcmanet really cares about independent pharmacies, then why the fuck is this happening? Could it be because, they really don’t care about independent pharmacies? We all know the truth!
Houston, we have a problem. And that problem is corporate greed and corruption. If @pcmanet really cares about independent pharmacies, then why the fuck is this happening? Could it be because, they really don’t care about independent pharmacies? We all know the truth!
Large national pharmacy organizations have confirmed that they are coming to the Express Scripts protest. I really thought that it could be just me at the protest. Instead, hundreds will be there. I'm appreciative. Last year, I was on a group call with some of the nation's…
How CVS Health is gaming PrEP medication claims and fueling the spread of HIV: CVS Health is tricking pharmacies into not filling pre-exposure prophylaxis (PrEP) medication for HIV prevention through drastic, deceptive up front underpayments. Generic Truvada has an acquisition…
Rep. Brian Stewart & myself are proudly working together to save our community pharmacies. @BrianStewartOH
Rep. Brian Stewart & myself are proudly working together to save our community pharmacies. @BrianStewartOH
So when we see insurance claims get diverted to a discount card upon adjudication, what’s stopping us from telling the patient that your insurance “doesn’t cover this” and charge them a fair cash price? Because technically the insurance isn’t covering it, the discount card is.
So when we see insurance claims get diverted to a discount card upon adjudication, what’s stopping us from telling the patient that your insurance “doesn’t cover this” and charge them a fair cash price? Because technically the insurance isn’t covering it, the discount card is.
When patients find out that we are losing substantial amounts of money filling their prescriptions, a lot of them are begging and pleading to pay us the difference so they don’t have to go somewhere else. If that were allowed, we’d just break even. Not a good business model.
Time is definitely not on our side. We need to have as much firepower as possible against the top money making PBMs in the “free market” that we have. We fight daily battles to keep serving as many of our patients as possible. The odds are constantly stacked against us.
Time is definitely not on our side. We need to have as much firepower as possible against the top money making PBMs in the “free market” that we have. We fight daily battles to keep serving as many of our patients as possible. The odds are constantly stacked against us.
@pcmanet Even AI knows you’re lying.
Another Monday and another week explaining to patients why their medications can't be dispensed due to below cost reimbursement by PBMs. PBMs are literally killing our population by disrupting access to medications.
This is exactly the same scenario as prescription insurance and how pharmacies are paid. Premiums, deductibles and copays all increase year after year, yet the professionals actually providing the services get paid less. ACA provided coverage, but coverage does not equal care
This is exactly the same scenario as prescription insurance and how pharmacies are paid. Premiums, deductibles and copays all increase year after year, yet the professionals actually providing the services get paid less. ACA provided coverage, but coverage does not equal care
@mcuban PBM contracts with pharmacies forbid pharmacies from complaining about their reimbursements to the employers who pay the PBMs. One of many ways secrecy destroys free markets
We’ve been doing plan comparisons during open enrollment for many years. We compare Medicare Part D plans and Medicare Advantage plans for our patients. Each year there are fewer and fewer plans that pay the pharmacy their acquisition cost on meds. That’s a big problem.
We’ve been doing plan comparisons during open enrollment for many years. We compare Medicare Part D plans and Medicare Advantage plans for our patients. Each year there are fewer and fewer plans that pay the pharmacy their acquisition cost on meds. That’s a big problem.
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When APhA and I start agreeing on shit you know its legit. PSAO's are a cancer, nothing but PBM's for running your biz. Remember, PSAO's dont make money unless they sign that PBM contract. They also aren't on the hook for your payroll or wholesaler bill either. Fucking lol.
As a reminder, if your pharmacy is part of a Pharmacy Services Administrative Organization (PSAO) network that chooses to enroll in a #PBM contract, that contract may supersede any other agreement your pharmacy has with a PBM. #forpharmacy
@pelterkevin @Pharmassists It’s not daunting at all. And absolutely, retail will not survive without LTC. You can start as a combo shop and/or start with Medical at Home programs.
@pelterkevin Worth it. Doing long term care at home not assisted living facilities. No IVs. The qualifications are easy. gerimedgso.com/pharmacy-type/… Went through these guys.
@pelterkevin @cvspharmacy No no no this can't be right. I was assured by pcma that independents are struggling because we don't have AI and other technologies. They wouldn't pay their own pharmacies $150 more.
@pelterkevin @cvspharmacy It’s called a very planned scam. Trying to get private practice/independents out of healthcare and everyone work for the oligarchy.
Beautiful!!
This is what real masculinity looks like!!!!! We need so much more than this. Men heard the call and responded.
@pelterkevin @BrandiChane @UnitedHealthGrp They will say we are fortunate that UHG owns Change healthcare or this would have been worse and that they will resurrect Change to an even better form of itself (these are statements they have already made in advance of the hearings - there is one coming in the House too)
Tell me again how the Big 3 PBMs negotiate with and support independent pharmacies. #Pharmacy #PBMabuse @JusticeATR @linakhanFTC @POTUS
@pelterkevin @cvspharmacy How could any person think these numbers are ok or normal.
🚨 Reimbursement by CVS Caremark to chain pharmacies is 43% HIGHER than for independent pharmacies in rural eastern North Carolina. How do rural patients get critical drugs when their local pharmacy can't fill due to PBM losses? *From 4/25 presentation NC State Health Plan mtg.
Large national pharmacy organizations have confirmed that they are coming to the Express Scripts protest. I really thought that it could be just me at the protest. Instead, hundreds will be there. I'm appreciative. Last year, I was on a group call with some of the nation's…
How CVS Health is gaming PrEP medication claims and fueling the spread of HIV: CVS Health is tricking pharmacies into not filling pre-exposure prophylaxis (PrEP) medication for HIV prevention through drastic, deceptive up front underpayments. Generic Truvada has an acquisition…
@pelterkevin Anything will look like acceleration from here. It’s at a standstill now.
@pelterkevin Bingo! We are the ones with the license to dispense, so we control the narrative. Bye bye PBMs and discount cards!
@pelterkevin Nothing, that's what you do. Use some of this absurdity to your advantage. Use "drug shortages" to your advantage. Send medicare/medicaid brands somewhere else but GIVE THEM A COMPLAINT FORM. Be smarter than the PBM and ride the storm out. Cost plus is coming; not sure when
Now United Healthcare's Optumrx has their own rx savings card. I guess they are competing with good rx. They want to gain greater market share anyway they can, while denying more claims on regular insurance
🚨🚨🚨 "FTC looking to accelerate inquiry into prescription-drug middlemen, chair says" marketwatch.com/story/ftc-look…
@pcmanet Even AI knows you’re lying.
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