I hate Express Scripts. I do. They are a pain in my ass. Not only do they have patients by the balls because they HAVE to use them for their drugs but Express Scripts uses this leverage to destroy my day. I have to fax EXACTLY the way they want things faxed with their form and many times that doesn’t work with my or any other doctors’ EMR. They don’t care. If you ignore them they alert the patient and both Express Scripts and the patient will start hounding you. And you become the bad guy.
They lie. They will tell patients they cannot use the medication they have been on forever without a reason and then force them to use something different. I have seen them claim another drug is in the same class when it was not even close.
And they are raking in the money.
PBMs serve as the middlemen in drug pricing system, by making deals with manufacturers and pharmacies. Their impact on our drug pricing system is enormous, in fact the three largest PBMs control an astounding 75-85 percent of the market and have upwards of $250 billion in estimated revenues. These companies are powerful forces in prescription negotiation but their reach is often obscured by a lack of transparency.
Because PBMs are the intermediary between drug manufacturers, pharmacies, and ultimately patients these companies hold sway over everything from pharmacy reimbursements, to what drugs are covered under formularies. Their influence is notable especially considering the lack of competition in the PBM space.
The only ones who “benefit” from these Pharmacy Benefit Managers or PBMs is themselves. I hate them all. And I am not the only one:
In a speech at the Food and Drug Law Institute Annual conference Thursday morning, (FDA Commissioner)Gottlieb said the U.S. doesn’t have a “truly free market” when it comes to drug prices, and suggested the federal government should re-examine whether drug rebates, which manufacturers pay to pharmacy benefit managers and insurers in exchange for more favorable coverage of their products, should be exempt from an anti-kickback law.
Finally! These middlemen are eating up any discounts meant for patients. Please get rid of them.
Let’s give an example of their trickery:
Just this week, Regeneron and Express Scripts announced a new deal for the cholesterol drug Praluent, in which Regeneron would significantly increase the rebate it pays on the drug in exchange for fewer obstacles for doctors to prescribe it — and the exclusion of the competitor drug from Amgen from coverage on Express Scripts’ largest formulary.
What a load of crap. Patients are pawns in this game as doctors are forced to switch medications on them because of some back room deal. It’s disgusting. I had to deal with it just last week with an ADD drug and an incontinence medication.
Please help me to continue to expose these crooks. Put your stories, where you have had to change medications for patients, here and let the world know of this lunacy.