Although they sure as hell don’t realize it, PBM’s (like ScamImp-..er..MedImpact) really do need small independents to continue their existence.
Imagine if you will, when all of the PBM’s have driven all of the little guys out of business. No more mom and pop stores as far as the eye can see. Sure, this might make the PBM’s happy because their executives got a 4.5 hochillion dollar bonus this year off of the backs of the little guys they put under, but now they have to deal with the two big angry gorillas of the pharmacy world: CVS and Walgreens.
Now, when MedImpact/Argus/etc sends their contracts to these retail giants with their AWP-25%+0.07 rates, do you think that the two big boys on the block are going to sign that? Hell no.
You see, now they sorta have to, because independents are still around to take care of the patients if the big “evil” chains refuse to sign that contract. Its illegal under anti-trust acts for true independents to collectively refuse to sign a contract. So you’ll find at least one pharmacy in town who’s stupid..er..CARING enough about “Patient Care” to sign that horribly low reimbursement rate. However when we’re all gone? It’ll just be the big boys, and they have a LOT of stores and don’t like to use much lube when it comes to the bottom line.
MedImpact will waltz up to CVS and offer something horribly stupid (because thats how PBM’s roll). CVS will look at the contract, send it around to each store for the pharmacist to wipe his/her ass on it, then return it to MedImpact. If they terminate CVS’s contract, then MedImpact’s patients just lost about 1/3 of the stores they can get their Rx’s filled. Walgreens will do the same thing, and eventually you’ll have a PBM that has no pharmacy to call home. See, the PBM’s will have eliminated all of the competition of the chains vs independents. They don’t realize it yet, but its slowly happening.
So whats a PBM to do? Easy, stop fucking over pharmacies. Take a REASONABLE fee for processing the prescription (ie: don’t make more per Rx then the person who is filling the prescription like you are doing now), PRINT THE RIGHT INFORMATION ON THE FUCKING ID CARDS (so we don’t have to call), and stop being fucking slimy crooked piece of shit banes of the pharmacy world.
Which brings me to my second issue: At what point do we throw down the gauntlet and put ‘patient care’ aside for our own livelihood and well being? At what point to we refuse to sign the new contract that these pieces of shits send our way and collectively stand as a profession against the abusive-husband that we call PBM’s? When do we grow the balls to tell Mrs Smith “I’m sorry, but we no longer take your insurance because doing so will cause us to go under. Go and complain to your insurance company about their processor”.
You know how I rant on here about how annoying and stupid patients can be? Now imagine them not yelling at me, but having them collectively yell at the PEOPLE THEY PAY to manage their pharmacy benefits. Of course trying to get pharmacists to do anything collectively is like herding cats; and we probably need a committee, a fancy name that has a cool acronym like DILDO, yearly meetings with pharmacy school students, a publication, lots of pictures of people who have NEVER WORKED A FUCKING HONEST DAY IN THEIR LIVES with fancy letters after their names, award ceremonies for “Something” of the year (which means absolutely nothing), scholarships, more publications, requests for membership dues, etc.
Thats right, I’m ragging on CPhA, APhA, ASCP, and the other alphabet soup organizations who want me to join their organization in exchange for magazines full of pictures of students who don’t have a fucking clue and old-guys trying to re-live their glory college days. WHY AREN’T ANY OF THESE “organizations” DOING SOMETHING ABOUT THE PBMS!!! Oh, because they have no idea about PBM’s because THEY DON’T WORK RETAIL. Before you can “Advance the Profession of Pharmacy(tm)(r)(wtf)” why don’t you try to fix the insurance clusterfuck that we have going on now. I know that its hard work shaking hands and getting your picture taken at the latest convention at the Marriott, but seriously, DO SOMETHING or we’re going to have to take your “patient care” that you so dearly hold true and preach to everyone about (btw, whens the last time you even SAW a patient? How about actually worked in a pharmacy?) and throw it aside so we can pay make payroll. Roll up your sleeves, put your fancy labcoat (with your name embroidered on it and has never seen a pink amoxicillin stain) aside, and GO AFTER THE PBMS!
The organizations should be going to the PBM’s and say “The cost of doing business is $x. At your reimbursement price, pharmacies CANNOT survive. We are going to recommend to ALL OF OUR MEMBERS to not sign up with your plan.” Anti-Trust? Sorta, but this is to all the members, most of which who are chain pharmacists and non-owners. Bah, its a pipe dream. Maybe they are doing this, but seriously to the guy in the trenches whom it effects, I see zero.
Realistically, I’m betting on the chains to do the dirty work based solely on their monopoly on the industry vs the people that I pay dues to represent how I see the profession.