Change.org Petition Update (JUN 12, 2022) — Click here to see the tweet referenced in the image.
What a great week! Thank you to the many patients that submitted comments to the Federal Trade Commission (FTC) about the many issues with pharmacy benefit managers or PBMs that force to their own mail order pharmacies. The FTC submitted subpoenas to PBMs that have merged with the mail order pharmacies that many are forced to, such as CVS Caremark, Optum RX, and Express Scripts.
Until we see true justice and change, we cannot declare victory. Please continue to share the petition, speak to your legislators, and file complaints with Boards of Pharmacy when issues arise with these corporations.
I will repeat this. Speak loudly about these issues. Scream injustice not only for yourself but for the many patients who have been harmed and whose lives are at risk in their hands. If you're able, reach out to the media in your area about these issues. It may be your story that will save lives.
In my comment, I included emails from USP, documentation, and articles. ** I forgot to mention the deception by PCMA in this NPR article when they claim to adhere to the FDA's non-existent temperature storage guidelines for mail order pharmacies. This should be considered fraud and deception.
Here is my submitted comment:
The monopolization of the pharmacy, PBM, and insurance industries is deteriorating America’s access to pharmacies and risking patients' lives of all ages.
In the US, parents are forced as the only coverage option to place their child's life-saving meds in only a bag and put them on a truck that reaches 100 to 170 degrees or in a mailbox without protection from the heat or freezing. No one warns them that their child’s life will be at risk.
Many feel helpless, without an option but to risk their child’s life as they can’t afford the full price demanded by PBMs as the insurance companies have merged with pharmacies and determine which pharmacies patients can use and how much patients pay at another pharmacy.
If a parent purposely put their child’s meds in only a bag in these temperatures, knowing that their child's life would be at risk, it would be called child abuse and patient neglect. In America, the Federal Trade Commission (FTC) and the Department of Justice have turned their heads to the abuse of patients from the wealthy oligopoly of powerful PBM, pharmacy, and insurance industries.
Please see the attached managed care article from 1998. The president of the Pharmaceutical Care Management Association (PCMA), the association for PBMs, laughed off concerns after a USPS study showed that trucks reach up to 170 degrees. Many patients complained of receiving medications with “dubious” efficacy from mail order pharmacies.
Please see the NPR article where 20 years later, a well-known consultant that receives money from PBMs, brushes off patients' concerns even today as lives are at risk. PBMs know that few will hold them accountable as no one is tracking the risks and the lives harmed. Filling regulatory boards with their affiliates ensures that this risking of lives is the status quo. The lives at risk can be seen across many consumer reports sites. Patients are unable to find protection or justice. After filing a complaint with the Dept of Insurance, the US Dept of Labor told me that although it may be unfair and unethical, it’s not illegal. Please see the referenced recording with the Department of Labor in the attached NBC Article.
In the US, a Board of Pharmacy such as Missouri’s State Board of Pharmacy, filled mostly with PBM and corporately affiliated pharmacy members, create a rule that mail order pharmacies must adhere to the drug manufacturers' guidelines or USP’s guidelines but fail to enforce their own rule despite complaints. Please see the attached communication from USP.
Due to the PBM oligopoly and vertical mergers, patients are forced to risk their lives with delays and interruptions in treatments as they are forced to a one-star rated mail order pharmacy owned by PBMs and insurance companies or to understaffed chain pharmacies cited with a 20-30% error rate by State Boards of Pharmacy.
PCMA claims that patients have access to independent pharmacies. In reality, patients lack true access as PBMs use affordability as a barrier to patient access to local pharmacies PBMs will charge up to 100% of the cash price if they use a pharmacy outside of the one affiliated with their PBM.
Others are steered to an insurance or PBM-owned pharmacy by claims that they will save money only to find out that the costs is actually higher than the cash price or copay at an independent pharmacy. Legislators removed senseless gag clauses by insurance companies that didn’t allow patients to know that the cash price would be lower than their copay. Upon removal of gag clauses, PBMs still discourage pharmacists from telling patients that the cash price is lower by charging fees to the pharmacists if a patient pays a cash price as the PBMs will mark patients as not adherent to medications. This metric does not consider that the patient filled their prescriptions but didn’t use their insurance coverage due to the higher price that the PBM would have charged.
In America, we see patients suffering and conditions deteriorating as they are forced to step therapy, not because the med is more affordable or effective but because it’s best for profits of the PBM.
Along with many patients and caregivers, I expect more out of our regulatory systems in our United States of America as we fight for our lives and our children’s lives mostly alone beside a small handful of brave pharmacists and physicians against the wealthiest corporations in our nation.
PCMA will often tell legislators and the FTC that “it’s complicated.” I, along with many others, disagree. The issue is quite simple. The failure of the FTC, legislators, and The Justice Department to protect consumers and patients from unfair and deceptive business practices and fraud is harming patients and deteriorating America’s safe access to medications. Due to this issue being overlooked for so long, our entire healthcare system is at risk. Please stop failing us. Save our pharmacies and pharmacy access. Save our lives.