CVS has been dominating the news lately: CVS-Aetna merger, CVS’s free drug deliveries, its efforts to curb opioid epidemic, etc. This post is about a recent litigation commenced by CVS against its ex-executive John Lavin to prevent him from working for a competitor, Pill Pack. After Amazon purchased PillPack last year, CVS’s
CVS-Aetna merger is finally… finalized
The CVS-Aetna merger has been one of the longest mergers in healthcare history. On September 4, 2019, the federal judge issued his final ruling approving the proposed settlement of the federal challenge to the merger. The judicial review took eleven months with multiple applications of the “public-interest” test as provided by the Tunney Act.
The
California pharmacies gather forces to push back a switch to NADAC
For a period of time, federal and state agencies made concerted efforts to control the cost of prescription drug spending, agreeing to use a reimbursement methodology that best reflects actual drug costs. Many states, however, used different methodologies to calculate drug cost. According to the U.S. Health and Human Services (HHS), such fluctuations in methodologies
Your pharmacy’s chance to stop below-cost and unfair reimbursements
A survey conducted by the National Community Pharmacists Association (NCPA) revealed that almost all independent pharmacies experience significant increase in drug acquisition cost while reimbursements are not simultaneously adjusted to reflect the increase. Often, reimbursements are adjusted but with remarkable delays. When pharmacies appeal these MAC reimbursements and delays in adjusting generic pricing, the appeals
Anticipating a CMS ruling on DIRs
In 2018, CMS proposed a Medicare rule that would eliminate retroactive DIR fees. One of the rationales for the rule was a colossal growth of DIRs between 2010 and 2017. During this period of time, DIRs grew by 45,000%.
As a result of this aggressive “performance enforcement” by PBMs, many pharmacies are reimbursed below cost
Are you ready for E-Prescribing?
More and more states are mandating e-prescribing. Some states require e-prescribing only for CII controlled substances, some for all controlled substances, and some require e-scripts for all medications.
States with current e-Rx mandate laws are:
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- Connecticut (e-prescribing for controlled substances only, no penalties for non-compliance)
- Maine (e-prescribing for controlled substances only, penalties provided)
- Minnesota (all
Threatened existence of independent pharmacies
This week I want to offer you an illustrative video “Pharmacoeconimics” prepared by a pharmacy owner – Loren Pierce – describing how DIR fees are killing his business.
In the video, Loren explains and shows his financial reports illustrating that in:
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2017, the pharmacy paid a total of $212,000 (1.2% of sales) in DIR
CVS-Aetna merger is finalized.
A new healthcare giant is here! CVS has closed a 69-billion merger with Aetna, the nation’s third-largest health insurer. The companies have recently announced that all necessary approvals had been obtained (New York was the last state to sign off on the deal).
Several states opposed the merger due to potential antitrust issues (federal regulatory
Walmart + Anthem deal
In attempt to counterbalance Amazon, Walmart has recently signed a deal with Anthem to provide Medicare enrollees with over-the-counter medications and health supplies at its stores.
For quite some time, Walmart has been making advances in the healthcare sector. For example, it already provides eye care at roughly 3,000 in-store vision centers and free health
Walgreens acquires DaVita pharmacy files
Walgreens has entered into agreement with DaVita to purchase its non-dialysis related prescription files, mostly under Medicare Part D. Currently, DaVita uses a drug distribution facility in Orlando for dispensing by mail non-dialysis medications. The deal with Walgreens is scheduled to finalize in late September, at which time the files of the facility will be