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DIR fees to pharmacies #3008972
01/10/20 06:37 PM
01/10/20 06:37 PM
Joined: Jul 2006
Posts: 6,519
Sylacauga
CAL Offline OP
14 point
CAL  Offline OP
14 point
Joined: Jul 2006
Posts: 6,519
Sylacauga
My industry is facing a challenge like never before. Insurance companies (PBMs) are charging us these fees after the point of sale. They have taken over 600k since January 2018 from my store alone! I really don’t know how we’re still in business. Below is a video summarizing what I’m talking about. Every day I learn a little more about this industry and every day I realize big pharma doesn’t give two schitts about anything except profit. Not that profit is a dirty word but they’re greed amazes me. I don’t think there’s a dirtier industry that exists. I believe a pimp/prostitute has a better and more transparent understanding of who’s getting paid what.

https://www.youtube.com/watch?v=GLbjj5O-VZA

Re: DIR fees to pharmacies [Re: CAL] #3008983
01/10/20 06:48 PM
01/10/20 06:48 PM
Joined: Aug 2014
Posts: 13,839
Mobile, AL
S
SouthBamaSlayer Offline
Gary's Fluffer
SouthBamaSlayer  Offline
Gary's Fluffer
S
Joined: Aug 2014
Posts: 13,839
Mobile, AL
So how does a PBM have the ability to charge you for something after the fact? If you buy aspirin from someone for $10, and they come back later and say you owe them $5, can you not tell them to pound sand?

Re: DIR fees to pharmacies [Re: CAL] #3009000
01/10/20 07:00 PM
01/10/20 07:00 PM
Joined: Aug 2003
Posts: 41,957
UR 6
top cat Offline
Freak of Nature
top cat  Offline
Freak of Nature
Joined: Aug 2003
Posts: 41,957
UR 6
I'll ask my daughter about it. She has really been catching it since the 1st and folks deductables are back.


LUCK:::; When presistence, dedication, perspiration and preparation meet up with opportunity!!!
- - - - - - - -A government big enough to give you everything you want, is big enough to take everything you have. Thomas Jeferson - - - - - - - -
Re: DIR fees to pharmacies [Re: CAL] #3009012
01/10/20 07:09 PM
01/10/20 07:09 PM
Joined: Feb 2002
Posts: 44,211
North Alabama
W
Wiley Coyote Offline
Freak of Nature
Wiley Coyote  Offline
Freak of Nature
W
Joined: Feb 2002
Posts: 44,211
North Alabama
The other day I saw where the CEO of one of the drug companies got $26.7M last year. I'm all for capitalism and making what you're worth but no individual is worth $26.7M per year. NOBODY!


I firmly believe that a double gallows should be constructed on the East Lawn of The White House. Politicians who willfully and shamelessly violate their oath to uphold and defend the Constitution of the United States of America should be swiftly tried and, upon conviction, publicly hanged at sunup the day after conviction. If multiple convicts are to be hanged they can choose with whom to share the gallows or names shall be drawn from the hangman's hat to be hanged 2 at a time.




NRA Life Member
Re: DIR fees to pharmacies [Re: Wiley Coyote] #3009042
01/10/20 07:34 PM
01/10/20 07:34 PM
Joined: Jan 2001
Posts: 10,607
Birmingham
W
wew3006 Offline
Booner
wew3006  Offline
Booner
W
Joined: Jan 2001
Posts: 10,607
Birmingham
Originally Posted by Wiley Coyote
The other day I saw where the CEO of one of the drug companies got $26.7M last year. I'm all for capitalism and making what you're worth but no individual is worth $26.7M per year. NOBODY!


Unless you are a lefty with a 98mph fastball

Re: DIR fees to pharmacies [Re: Wiley Coyote] #3009059
01/10/20 07:46 PM
01/10/20 07:46 PM
Joined: Aug 2001
Posts: 63,355
Luverne, AL
Skinny Offline
GUVNER
Skinny  Offline
GUVNER
Joined: Aug 2001
Posts: 63,355
Luverne, AL
Originally Posted by Wiley Coyote
The other day I saw where the CEO of one of the drug companies got $26.7M last year. I'm all for capitalism and making what you're worth but no individual is worth $26.7M per year. NOBODY!


Gates and Bezos make that much taking a dump.


Never Trust Government

"You can be broke but you cant be poor." Ruthie-May Webster
Re: DIR fees to pharmacies [Re: CAL] #3009072
01/10/20 08:02 PM
01/10/20 08:02 PM
Joined: Aug 2006
Posts: 8,833
Andalusia, Covington County, A...
TexasHuntress Offline
14 point
TexasHuntress  Offline
14 point
Joined: Aug 2006
Posts: 8,833
Andalusia, Covington County, A...
Our youngest absolutely believes that no individual should be a billionaire. We have both explained why capitalism is a good thing and he understands and doesn’t completely disagree with it. But, like Wiley said, there are some folks who make an obscene amount of money and everyone else under them are seriously underpaid by comparison.

I had read an article in our local paper about this pharmacy deal and how some local pharmacies were probably looking at laying some people off because of this deal.

Lots of people have had negative feelings about big pharma for several years. It isn’t hard to believe that there are some cures for things that simply are not allowed to be manufactured because there would be some decline in the bottom line.


If you live to be a hundred, I want to live to be a hundred minus one day, so I never have to live without you.---Winnie the Pooh
Re: DIR fees to pharmacies [Re: SouthBamaSlayer] #3009076
01/10/20 08:04 PM
01/10/20 08:04 PM
Joined: Jul 2006
Posts: 6,519
Sylacauga
CAL Offline OP
14 point
CAL  Offline OP
14 point
Joined: Jul 2006
Posts: 6,519
Sylacauga
Originally Posted by SouthBamaSlayer
So how does a PBM have the ability to charge you for something after the fact? If you buy aspirin from someone for $10, and they come back later and say you owe them $5, can you not tell them to pound sand?


No other reason than just because they can. Unlimited power and control.

Re: DIR fees to pharmacies [Re: CAL] #3009100
01/10/20 08:21 PM
01/10/20 08:21 PM
Joined: Jul 2013
Posts: 5,025
Gurley, Alabama
S
Standbanger Offline
12 point
Standbanger  Offline
12 point
S
Joined: Jul 2013
Posts: 5,025
Gurley, Alabama
MLB, NBA, NFL pay them wages to star afletes

Re: DIR fees to pharmacies [Re: CAL] #3009130
01/10/20 08:45 PM
01/10/20 08:45 PM
Joined: Aug 2014
Posts: 13,839
Mobile, AL
S
SouthBamaSlayer Offline
Gary's Fluffer
SouthBamaSlayer  Offline
Gary's Fluffer
S
Joined: Aug 2014
Posts: 13,839
Mobile, AL
Originally Posted by CAL
Originally Posted by SouthBamaSlayer
So how does a PBM have the ability to charge you for something after the fact? If you buy aspirin from someone for $10, and they come back later and say you owe them $5, can you not tell them to pound sand?


No other reason than just because they can. Unlimited power and control.

But what would happen if you told them to kiss your ass?

Re: DIR fees to pharmacies [Re: SouthBamaSlayer] #3009140
01/10/20 08:51 PM
01/10/20 08:51 PM
Joined: Jul 2006
Posts: 6,519
Sylacauga
CAL Offline OP
14 point
CAL  Offline OP
14 point
Joined: Jul 2006
Posts: 6,519
Sylacauga
Originally Posted by SouthBamaSlayer
Originally Posted by CAL
Originally Posted by SouthBamaSlayer
So how does a PBM have the ability to charge you for something after the fact? If you buy aspirin from someone for $10, and they come back later and say you owe them $5, can you not tell them to pound sand?


No other reason than just because they can. Unlimited power and control.

But what would happen if you told them to kiss your ass?

You get kicked out of their network and are no longer able to accept that insurance. Not only that but it also could blacklist us from being able to accept the few plans that are still profitable.

Re: DIR fees to pharmacies [Re: CAL] #3009146
01/10/20 09:00 PM
01/10/20 09:00 PM
Joined: Jul 2006
Posts: 6,519
Sylacauga
CAL Offline OP
14 point
CAL  Offline OP
14 point
Joined: Jul 2006
Posts: 6,519
Sylacauga
Another thing, this is money the pbms are taking from us that is also pushing people towards the gap or donut hole in which the customer is responsible for a large portion of their medication. It’s so dirty. NO other business model works this way. It’s all a scam!

Re: DIR fees to pharmacies [Re: TexasHuntress] #3009260
01/10/20 10:54 PM
01/10/20 10:54 PM
Joined: Jan 2018
Posts: 833
Clanton,Alabama
D
Dublgrumpy Offline
6 point
Dublgrumpy  Offline
6 point
D
Joined: Jan 2018
Posts: 833
Clanton,Alabama
Originally Posted by TexasHuntress
Our youngest absolutely believes that no individual should be a billionaire. We have both explained why capitalism is a good thing and he understands and doesn’t completely disagree with it. But, like Wiley said, there are some folks who make an obscene amount of money and everyone else under them are seriously underpaid by comparison.

I had read an article in our local paper about this pharmacy deal and how some local pharmacies were probably looking at laying some people off because of this deal.

Lots of people have had negative feelings about big pharma for several years. It isn’t hard to believe that there are some cures for things that simply are not allowed to be manufactured because there would be some decline in the bottom line.

You had dang well better believe there are cures out there for things that big pharma doesn't want you to know about. They not only don't want you to know, but are actively involved in ensuring you never find out or use scare tactics to keep folks away from anything that hurts their bottom line.

Re: DIR fees to pharmacies [Re: CAL] #3009331
01/11/20 04:15 AM
01/11/20 04:15 AM
Joined: Aug 2006
Posts: 8,833
Andalusia, Covington County, A...
TexasHuntress Offline
14 point
TexasHuntress  Offline
14 point
Joined: Aug 2006
Posts: 8,833
Andalusia, Covington County, A...
Originally Posted by CAL
Originally Posted by SouthBamaSlayer
Originally Posted by CAL
Originally Posted by SouthBamaSlayer
So how does a PBM have the ability to charge you for something after the fact? If you buy aspirin from someone for $10, and they come back later and say you owe them $5, can you not tell them to pound sand?


No other reason than just because they can. Unlimited power and control.

But what would happen if you told them to kiss your ass?

You get kicked out of their network and are no longer able to accept that insurance. Not only that but it also could blacklist us from being able to accept the few plans that are still profitable.


Is there a pharmacists lobby or national union that could put some significant pressure on these companies to change that? If there is not, then perhaps one should be formed.

It this day and time, is it remotely possible for a drug store to keep the doors open if they do not accept drug plans from the insurance companies? I ask because I have been told more than once that a particular prescription I had would actually be cheaper to pay all of out of pocket if I got the generic than the copay was for the name brand.


If you live to be a hundred, I want to live to be a hundred minus one day, so I never have to live without you.---Winnie the Pooh
Re: DIR fees to pharmacies [Re: CAL] #3009332
01/11/20 04:59 AM
01/11/20 04:59 AM
Joined: Jul 2006
Posts: 6,519
Sylacauga
CAL Offline OP
14 point
CAL  Offline OP
14 point
Joined: Jul 2006
Posts: 6,519
Sylacauga

Is there a pharmacists lobby or national union that could put some significant pressure on these companies to change that? If there is not, then perhaps one should be formed.

It this day and time, is it remotely possible for a drug store to keep the doors open if they do not accept drug plans from the insurance companies? I ask because I have been told more than once that a particular prescription I had would actually be cheaper to pay all of out of pocket if I got the generic than the copay was for the name brand.[/quote]

Yes we have a lobbying group that’s supposedly trying to get some relief.

Your second point is a whole different issue. MANY insurers require us to dispense the brand product when a much cheaper generic is available. There’s only one reason for this. Insurance is getting kickbacks from drug makers for doing so. It’s maddening to see it happen. You should be screaming at your elected officials about this. It’s a complete abuse of their power and the consumer is paying the price.

Re: DIR fees to pharmacies [Re: CAL] #3009379
01/11/20 08:08 AM
01/11/20 08:08 AM
Joined: Sep 2007
Posts: 7,561
Hartselle, AL
trlrdrdave Offline
14 point
trlrdrdave  Offline
14 point
Joined: Sep 2007
Posts: 7,561
Hartselle, AL
CAL...I have seen first hand using GoodRX I bought pills for 1.38 a pill at Walmart. At Walgreens they are 87 a pill. How does that happen?


"In time of war, send me all the Alabamians you can get, but in time of peace, for Lord's sake, send them to somebody else." General Edward H. Plummer

"Blessed are those who, in the face of death, think only about the front sight." Jeff Cooper
Re: DIR fees to pharmacies [Re: CAL] #3009390
01/11/20 08:27 AM
01/11/20 08:27 AM
Joined: Dec 2012
Posts: 3,451
Coosa County
T
Turkey Offline
10 point
Turkey  Offline
10 point
T
Joined: Dec 2012
Posts: 3,451
Coosa County
The irony in this post is uncanny. I’d never heard of this problem until yesterday. I’ve had a series of meetings with our state rep. About another piece of legislation we’re trying to get his help with. After our meeting, he talked a good 20 minutes about this problem and what it is doing to small pharmacies. Makes me wonder if you also met with him.

Re: DIR fees to pharmacies [Re: CAL] #3009496
01/11/20 10:50 AM
01/11/20 10:50 AM
Joined: Oct 2009
Posts: 5,641
Henry county
coldtrail Offline
12 point
coldtrail  Offline
12 point
Joined: Oct 2009
Posts: 5,641
Henry county
Large publicly traded companies pay off politicians. This coupled with the govenrment take over of medical insurance short makes it impossible to change anything. Short of a revolt we are screwed.


"And the days that I keep my gratitude
Higher than my expectations
Well, I have really good days" Ray Wylie Hubbard
Re: DIR fees to pharmacies [Re: TexasHuntress] #3009534
01/11/20 11:38 AM
01/11/20 11:38 AM
Joined: Dec 2007
Posts: 1,195
Cropwell, AL
slgunnel Offline
6 point
slgunnel  Offline
6 point
Joined: Dec 2007
Posts: 1,195
Cropwell, AL
Originally Posted by TexasHuntress
t isn’t hard to believe that there are some cures for things that simply are not allowed to be manufactured because there would be some decline in the bottom line.


There's more $$ to be made off treatment than offering a cure. I can't confirm that, but I do believe it.

Some believe that it secretly helps with population control as well. I honestly can't say there isn't some truth behind that assumption.


KEEP WORKING - Millions on Welfare depend on you...
Re: DIR fees to pharmacies [Re: slgunnel] #3009549
01/11/20 11:45 AM
01/11/20 11:45 AM
Joined: Aug 2001
Posts: 63,355
Luverne, AL
Skinny Offline
GUVNER
Skinny  Offline
GUVNER
Joined: Aug 2001
Posts: 63,355
Luverne, AL
Originally Posted by slgunnel
Originally Posted by TexasHuntress
t isn’t hard to believe that there are some cures for things that simply are not allowed to be manufactured because there would be some decline in the bottom line.


There's more $$ to be made off treatment than offering a cure. I can't confirm that, but I do believe it.

Some believe that it secretly helps with population control as well. I honestly can't say there isn't some truth behind that assumption.


Thats the way it works for Malaria. Yellow fever still kills bunches of people in Africa but their aint no money to be made fixing it though it is easily treatable and fixable.


Never Trust Government

"You can be broke but you cant be poor." Ruthie-May Webster
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