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Specialty Pharmacy Scam - Same Drug Ranges from $37.41 to $2,172 

AHealthcareZ - Healthcare Finance Explained
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Generic Specialty Pharmacy Scam. The generic version of the Multiple Sclerosis Drug Tecfidera is called Dimethyl Fumarate. This generic medication has been available since 2020.
Usually when a drug becomes generic its price goes WAY DOWN.
However, the Dimethyl Fumarate has a HUGE variability in cost depending on which pharmacy you use to fill it.
Grocery store pharmacies like HEB, Giant, Publix and Jewel-Osco sell Dimethyl Fumarate for $37 to $104 for a one month supply.
However, Costco, Walmart, Walgreens and CVS sell the exact same generic medication for $1,500 to $2,171.
That's 58 TIMES more expensive.
For employer-sponsored health insurance plans, that higher cost is being paid by the employer.
Solution: Exclude Dimethyl Fumarate from your PBM formulary, have plan members pay cash at the lower cost pharmacies and then reimburse them the cost.
You don't even need to use a Patient Assistance Program.
Sources:
www.goodrx.com/tecfidera?dosa...
multiplesclerosisnewstoday.co...
www.mymsteam.com/resources/wh....
corporate.walmart.com/newsroo...
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24 июн 2023

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Комментарии : 21   
@unebonnevie
@unebonnevie Год назад
Thank you for pointing out the greed at the stores (Costco/Walmart/Walgreens/CVS) that are actually wolves in sheep clothing, tricking people that they are actually saving money for their customers! This is a very shameful thing done by these BIG chains of stores!
@ahealthcarez
@ahealthcarez Год назад
Caveat Emptor… gotta watch out!
@unebonnevie
@unebonnevie Год назад
Perhaps Dr. Bricker is a few of the people that sow the seed of healthcare reform or revolt, for that matter, in this country. Appreciate your channel, Dr. Bricker!
@ahealthcarez
@ahealthcarez Год назад
Thank you for watching and for your support.
@Laremy
@Laremy Год назад
Definitely one of the best, saying the quiet parts out loud!
@TakiffanyWilliams
@TakiffanyWilliams 10 месяцев назад
thanks for this informative video. I work PBM and I see this type of foolery everyday, and its sad.
@drshanep
@drshanep Год назад
ALWAY check the cash price even if insurance.
@ahealthcarez
@ahealthcarez Год назад
True. Thank you for watching.
@sue5230
@sue5230 5 месяцев назад
Thank you, Dr. Bricker! Unfortunately, I only have a Walmart near me!
@ahealthcarez
@ahealthcarez 5 месяцев назад
Thank you for watching.
@fabianfabianfabianpg
@fabianfabianfabianpg 4 месяца назад
Useful
@ahealthcarez
@ahealthcarez 4 месяца назад
Thank you for watching.
@neilturnage5620
@neilturnage5620 11 месяцев назад
Great video. Why do you recommend that SF employers simply elect to remove Dimethyl Fumarate from formulary? Couldn't an employer just continue to cover the drug and communicate to employees to utilize GoodRx outside of insurance? What's the benefit of removing the drug from the formulary?
@ahealthcarez
@ahealthcarez 11 месяцев назад
To ensure GoodRx usage. If still on formulary, people will still use their insurance out of habit/ignorance.
@utubesbydano
@utubesbydano Год назад
I may be missing something. If both pricing examples (GoodRx) vs (Walmart, Costco, etc) are based off of, or similar to various PBM's contractual Specialty pricing......and let's say a typical PBM's contractual pricing for Specialty is AWP - 20-25%. How do we end up with such a huge price disparity if we don't see similar PBM contractual pricing differences for Specialty? Hope this makes sense. Thanks!
@ahealthcarez
@ahealthcarez Год назад
Grea question. The problem is with the AWP - 25% assumption. It is highly variable by specific drug. The aggregate number cannot be applied to each drug.
@MPS72192
@MPS72192 9 месяцев назад
Yes, but in aggergate they group will be trued up to 20.25%. @@ahealthcarez
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