I'm a personal friend of a PBM CEO. Long story short, I dated his daughter for 1-2 years. I myself work in drug development and confronted him about this a few years ago, knowing the games they play. He more or less is a figurehead of his organization just to spout off numbers in how much they saved customers money by staying on his side of the game. He was on an interview on CBS The View repeating the same thing. "Drug Companies make the prices and the PBMs are working for the consumer," when this is not correct at all. Seeing the retail end of it in pharmaceuticals is even more horrifying. At least in the manufacturing end, we're still able to make money. But they really just give you guys without lube.
Very educational and absolutely depressing. Unfortunately, his reward for this exposé will most likely be the PBM’s ripping him an extra bodily orifice all whilest running him, along with his morals intact, swiftly out of business. As a practicing pharmacist for more than 50 years I, among other pharmacists predicted the demise of independent pharmacies decades ago when we, as pharmacist, acted to fill out claims for the insured and then forwarded them to the insurance company - That practice was NOT in the best interest of the profession. A contract existed between the insured and the insurance company. NOT THE PHARMACIST.I predict Mr. Sullivan will get very little support from practicing pharmacist NOW because WE, as a profession are too wimpy and are not organized enough to go after ANYONE threatening our beloved profession. On the other hand, there are plenty of politicians vying for permanent political careers that will jump on the band wagon and…and…then jump in bed with the lobbyist long enough to drag out any repayment of monies stolen or see any positive reform for a few years. I would certainly be entertained and surprised when pharmacist Sullivan’s expert presentation ignites any significant change in the reimbursement structure in my life time. NEVER-THE-LESS - Go brother! GO! I will support this professional grass root movement at the expense of my time, my spirit and certainly my money - well, what little there is remaining… I’m so proud of you!dlrogansr
Great explanation. I’ve been a pharmacist nearly 30 years. I work mostly in a hospital setting but have always worked part-time in retail. My boss in retail sent me this link to watch. I knew about some of this, but your explanation is a real eye opener. Unfortunately nothing is going to change. The lobbyists have too much money, and the pharmacy associations have very little clout. I’m glad I am close to retirement.
Independents and grocery chains should link up and everybody pay for a lobby/union that can take on these criminals. Go to HealthMart that supplies most of these guys and send out offers to create these lobbies. We all link up and contribute some small amount of money that can equate to millions with everyone involved that we can then take on PBMs with.
Hi Dr. Sullivan. Wonderful video! Thank you for taking the time to make it. I’d love to share some of the points you’ve made with some of my coworkers and was wondering if your slides were available to share (ie, easily printable perhaps? I’m not a computer person). Either way, thank you!
From New Zealand. You guys need National buying formulary (our PHARMAC). Can you get prescribers to always use drug name so that you can fill with cheapest generic as cash script? It will be far cheaper for the customer, especially if every pharmacy offers it (bulk market for generic manufacturers)
Legislation. Legislation. Legislation. Put the PBMs in the public spotlight of how much they are carving out of the healthcare industry for what good of the patient? For too long they were the hidden 3rd party. People know the pharmacist, the doctor, themselves and the insurers....NO ONE knows about PBMs...>YET< Call up your representative and support legislation that regulates the PBMs to death...and it IS happening! 2019-2020 is going to be an interest time to see the changes in legislation to stop the horrific abuse PBMs have inflicted on the healthcare industry and the patients.
It is very educational, can you please tell us about is blink health is better. They also claim that they are PBM, but their prices are pretty transparent, which I love.
Valuable descriptions. Even better if we all knew the health approaches that are anti-everything, since body inputs affect body outputs. Health is a fact thing, not majority vote, regulatory capture or profit thing (we're proving that with our kids). Plus the FDA and USDA don't normalize for traditional health approaches when testing pharmaceuticals (that would admit they exist, if they know them). (Good thing AMZN is in health benefits. Sickness benefits is crowded, as you point out.) Seems to me.
I'm interested. I'm new to this pharmacy game. My wife recently passed away and I inherited her pharmacy. I've been analyzing why the business is no longer profitable. It all leads to the PBMs. It's time to fight back.
You are independent pharmacist who owns an independent pharmacy store. Surely you’re the loser in the PBM environment. No. 1. You are willing to lose 500-600 dollars for a prescription sometimes. PBM does not force you to fill up that prescription. Why are you silly to not only stock the drug, but also happy to dispense the drug. No. 2. PBM signs the contract with health care insurance and government payers to decide how to use the rebate. Health care insurance and government payers have their own staffs to calculate the rebates. Rebate calculation from PBM and payers are consistent to each other. Typically payers recoup almost all the rebate, including CMS Medicare payers. No. 3. You are not required to sign the contract with PBM. If you want to hire 2-3 staffs to bill claims to 100 payers, you are allowed to skip PBM and just deal with payers directly. PBM probably make money because PBM save you 2-3 employees. I agree with this pharmacist that the rebate program should go away. But government payers love it.
This video would be tremendously more effective if it were polished, well-made - instead of a guy in front of a camera, thinking through what he wants to say, and figuring out how to phrase it as along he goes. You can't tell a compelling story this way. As your starting point, at the very least, gather a script; use editing; incorporate some relevant pictures. As it stands, your video fails in its goal, despite its good intentions.
I disagree. This is a grass-roots video. If you want a polished, animated, 3D-effects video, there are many videos out there talking about the same thing that have your "polish".
When your target audience includes people who want to learn about PBMs, it's probably a safe bet to assume they're not going to care about the formalities. Maybe he'd get more initial clicks but they'd all stop 2 seconds in. Lol
