Did you get the “CVS” text yesterday? (1 Viewer)

[HoustonGold]

Did you get the CVS text yesterday stating stores in Louisiana would be shutting down in Louisiana if you don’t act now? Well here is what is going on,

The Breakdown: CVS issues plea to Louisiana customers amid last-minute legislation

Did you get that text from CVS? Here’s what it really means—and how a last-minute bill in Baton Rouge could change how you get your meds.

www.wwltv.com

If you got ExtraBucks just sitting in your account. Spend them now.

 

[Sun Wukong]

I never had a problem with my insurance covering prescriptions. Since we adopted CVS Caremark as a PBM, I have had them refuse to cover multiple prescriptions, refuse to fill prescriptions I have been on for years due to "lack of prior authorization" and generally engage in behavior that leaves both my doctor and pharmacy confused and perplexed. They literally sent me a letter refusing to cover a medication and then in the list of approved alternatives...was the same medication.

I have friends and family that were suddenly told they were no longer covered for scripts they had had for years. My nephew has restrictive airway disease and has had it under control for a while due to them finally finding the right meds to use for his inhaler. Low and behold, CVS comes along and says "We're not covering that anymore.' They switched him to a cheaper option which didn't work as well, and his pulmonologist said on his last visit it was the first regression in lung function he'd had since he was a toddler. Even after the pulmonologist personally wrote an appeal to CVS they refused to budge.

CVS can eat sheet and forking die.

 

[guidomerkinsrules]

yes got it
the Enemy of my enemy is also my enemy

 

[Zack Lee]

also got it.

 

[Sailorsaint]

In today's political climate, if something has "overwhelming bipartisan support", it's probably a double edged sword. I don't use CVS or Walmart or any big name pharmacy, just the small town local pharmacy, so I don't have a horse in this race. But from the article, it sounds like a good bill and that CVS needs a slap down.

 

[Optimus Prime]

I have friends and family that were suddenly told they were no longer covered for scripts they had had for years. My nephew has restrictive airway disease and has had it under control for a while due to them finally finding the right meds to use for his inhaler. Low and behold, CVS comes along and says "We're not covering that anymore.' They switched him to a cheaper option which didn't work as well, and his pulmonologist said on his last visit it was the first regression in lung function he'd had since he was a toddler. Even after the pulmonologist personally wrote an appeal to CVS they refused to budge.

CVS can eat sheet and forking die.

Could have tragic consequences
=====================

When 22-year-old Cole Schmidtknecht tried to get a refill on the inhaler prescribed by his doctor to prevent asthma attacks, the medication that had formerly cost him less than $70 at his Appleton, Wisconsin pharmacy was now priced at more than $500, according to Cole’s father, Bil Schmidtknecht.

Stunned, Cole left the store with a medication designed to stop asthma attacks once they start, but without the Advair Diskus inhaler he needed to prevent attacks from happening in the first place.

Five days after his pharmacy visit last year, Cole had a severe asthma attack, stopped breathing and collapsed. He never regained consciousness and died. Doctors attributed his death to asthma.

His parents, Bil and Shanon Schmidtknecht, blame what they say is a dysfunctional system where medications can change in price overnight and without notice.

A part of the insurance system that many Americans don’t know about was responsible for the spike in Cole’s inhaler price. Pharmacy benefit managers, or PBMs, are the middlemen that control behind the scenes which drugs will be on an insurance company’s list of covered medications (called its formulary).

They add or subtract medications through a process that emphasizes profits for the pharmacy benefit manager by way of “rebates” from drug makers, said Gerard Anderson, a professor of health policy and management at the Johns Hopkins University Bloomberg School of Public Health.

PBMs “are looking for the drug that makes them the most money,” Andersen said

“It’s insane that it’s happening in America,” Bil Schmidknecht said. “It’s not broken. It’s designed to work this way. It’s just hurting us.”

The Schmidtknechts are pushing for legislation that would require a 90-day warning when an insurance company’s formulary is changed. They are also suing Optum Rx, the PBM that took Cole’s Advair Diskus off his insurance company’s formulary, and Walgreens, his pharmacy, which, the Schmidtknechts say, didn’t offer Cole a way to control his asthma while another solution could be found.

The lawsuit claims that Cole did not get the required 30 days’ notice of the change, that his doctor wasn’t contacted and that the pharmacy didn’t provide Cole with any more affordable options..............

Parents sue over son's asthma death days after inhaler price soared without warning

Cole Schmidtknecht, 22, had insurance but couldn’t afford to refill his asthma inhaler after the cost jumped from $70 to more than $500.

www.nbcnews.com

 

[Sun Wukong]

Could have tragic consequences
=====================

When 22-year-old Cole Schmidtknecht tried to get a refill on the inhaler prescribed by his doctor to prevent asthma attacks, the medication that had formerly cost him less than $70 at his Appleton, Wisconsin pharmacy was now priced at more than $500, according to Cole’s father, Bil Schmidtknecht.

Stunned, Cole left the store with a medication designed to stop asthma attacks once they start, but without the Advair Diskus inhaler he needed to prevent attacks from happening in the first place.

Five days after his pharmacy visit last year, Cole had a severe asthma attack, stopped breathing and collapsed. He never regained consciousness and died. Doctors attributed his death to asthma.

His parents, Bil and Shanon Schmidtknecht, blame what they say is a dysfunctional system where medications can change in price overnight and without notice.

A part of the insurance system that many Americans don’t know about was responsible for the spike in Cole’s inhaler price. Pharmacy benefit managers, or PBMs, are the middlemen that control behind the scenes which drugs will be on an insurance company’s list of covered medications (called its formulary).

They add or subtract medications through a process that emphasizes profits for the pharmacy benefit manager by way of “rebates” from drug makers, said Gerard Anderson, a professor of health policy and management at the Johns Hopkins University Bloomberg School of Public Health.

PBMs “are looking for the drug that makes them the most money,” Andersen said

“It’s insane that it’s happening in America,” Bil Schmidknecht said. “It’s not broken. It’s designed to work this way. It’s just hurting us.”

The Schmidtknechts are pushing for legislation that would require a 90-day warning when an insurance company’s formulary is changed. They are also suing Optum Rx, the PBM that took Cole’s Advair Diskus off his insurance company’s formulary, and Walgreens, his pharmacy, which, the Schmidtknechts say, didn’t offer Cole a way to control his asthma while another solution could be found.

The lawsuit claims that Cole did not get the required 30 days’ notice of the change, that his doctor wasn’t contacted and that the pharmacy didn’t provide Cole with any more affordable options..............

Parents sue over son's asthma death days after inhaler price soared without warning

Cole Schmidtknecht, 22, had insurance but couldn’t afford to refill his asthma inhaler after the cost jumped from $70 to more than $500.

www.nbcnews.com

PBM's are literally just a completely unnecessary middleman that exists to line their own pockets at the expense of the patient. They are also often institutionally inept on top of this, so you get a heaping dose of both malice and incompetence when dealing with them. All the while, there is no good reason for them to exist at all. The wonders of our corporate dystopia never cease.

 

[efil4stnias]

So wait, CVS pharmacy is owned by a PBM?

and thats NOT a conflict of interest???

 

[Sun Wukong]

So wait, CVS pharmacy is owned by a PBM?

and thats NOT a conflict of interest???

CVS Health owns CVS Pharmacies and CVS Caremark, which is the PBM. They are technically separate parts under the same umbrella, but it's all dirty corporate incest at the end of the day.

 

[CapitalCitySaint]

I never had a problem with my insurance covering prescriptions. Since we adopted CVS Caremark as a PBM, I have had them refuse to cover multiple prescriptions, refuse to fill prescriptions I have been on for years due to "lack of prior authorization" and generally engage in behavior that leaves both my doctor and pharmacy confused and perplexed. They literally sent me a letter refusing to cover a medication and then in the list of approved alternatives...was the same medication.

I have friends and family that were suddenly told they were no longer covered for scripts they had had for years. My nephew has restrictive airway disease and has had it under control for a while due to them finally finding the right meds to use for his inhaler. Low and behold, CVS comes along and says "We're not covering that anymore.' They switched him to a cheaper option which didn't work as well, and his pulmonologist said on his last visit it was the first regression in lung function he'd had since he was a toddler. Even after the pulmonologist personally wrote an appeal to CVS they refused to budge.

CVS can eat sheet and forking die.

Owned by United… so no surprise.

 

[buzd]

I don't really know anything about the legislation, but CVS is close to my house, and is the preferred pharmacy of my insurance. I rarely have issues with them. They are 5 million% better than Walgreen's.

 

[Mr. Sparkle]

I don't really know anything about the legislation, but CVS is close to my house, and is the preferred pharmacy of my insurance. I rarely have issues with them. They are 5 million% better than Walgreen's.

I find that chain pharmacies are sort of like airlines - the worst one in the country is whatever you flew last.

 

[Paul]

dirty corporate incest

You have got to coin this.

 

[Grumpy Old Manatee]

Owned by United… so no surprise.

Are you sure about that? I don’t think that is correct. Can you provide any evidence of this claim?