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Saturday, August 6, 2011

Clash of the Titans

In case you have been hiding in a bomb shelter for the last few months you missed the announcement that Walgreen's was not going to renew its contract with Express Scripts for prescription processing at the end of 2011. They have already dropped E.S. employee rx processing and are ready to give the rest of them the old "heave ho".

Why would a pharmacy business give up a ton of customers, including all military rx insured? Due to craptacularly low reimbursement rates from the processor (ie E.S.). Why lose a sh*tload of money if you don't have to. This is not the first time Walgreen's has gone toe to toe with an rx insurance provider. There have been many instances in the past with different state medicaid programs and other rx processors in which Walgreen's just said "No". Quite frankly I don't blame them one bit.

I say f*ck you Wal-Mart (and Sam's Club) with your $4 rx (and no charge to mail it to your house), and a smaller f*ck you to Target for jumping on the $4 band wagon (No hard feelings Target I still love you, it's just a matter of principle.) Oh yeah, I didn't forget you Costco, f*ck you too with $6 prescriptions and a "you don't have to be a member to use the pharmacy" policy, and a special lick my twat to all the grocery store pharmacies with the list of free antibiotics, and to any other rx chain that has such equally bastardizing low ball tactics to get business.

This pricing bullsh*t is what makes insurance providers believe they are entitled to craptacularly low reimbursement rates because if we can fill over 300 drugs for $4 then we must not really need AWP (average wholesale price) + a finger in your ass for reimbursement, which is the industry standard right now. This means we will get less than AWP and not even the uncomfortable "how you durin" of a finger in the ass for employee hours, supplies, drugs, utilities, patient counseling, vaccinations, etc. You know who gets the really short end of the stick? Independent pharmacies that are subjected to the same craptacular reimbursement rates with a much higher drug acquisition cost. Even being in a buying co-op isn't gonna save most of them.

As a "f*ck you" return serve to Walgreen's, Express Scripts is trying to buy Medco, which is another huge rx benefit provider. E.S. states that they will "save money by being a bigger company" but we all know they just want to bend Walgreen's over to get them to take the craptacularly low reimbursement rates and the rest of the retail pharmacies will have to bend over and take it too. This is a bitter pill to swallow indeed. The only hope is that the Federal Trade Commission prevents the buy because E.S. will then control about 40% of the prescription market and will have way too much control over the industry.

If the FTC does as wonderful a job as the Congressional budget fix then the pseudo-comfortable "we can make a few bucks and keep the lights on" days of retail pharmacy will be at an end. The new dawn will bring obliteration of what was once a landscape of semi-prosperous independent pharmacies to a place where only chain retail pharmacies remain. Just one more American dream shat upon by the greed of others. Go Team!

14 comments:

Anonymous said...

they are buying medco not UHC

Nathan said...

Well everyone seems to want single payer healthcare, so you should all be eating this up.

Filet-o-bitch RPh said...

This is an amazing post! So very true...

Anonymous said...

Nathan, dear, single-payer allows the public to attempt to rein in only one scalaway, rather then try to figure out the trillion loopholes that every other singlet in healthcare pops up with.

Big 'N Tasty RPH said...

fixed

Big 'N Tasty RPH said...
This comment has been removed by the author.
Big 'N Tasty RPH said...

That 1 billion dollars of projected savings that express scripts plans to save by merging will come directly from the financial reimbursement rape of retail pharmacies, mandatory mail order from their mail order service for the insured on all maintenance meds, employee downsizing and a restructuring of resources...ie fire, rape, pillage their way right back to the dark ages...just like all other mergers in all business sectors...

mimo said...

I work at a family owned drug store that has a few locations. We just can't handle all the 4.00 crap. There are so many customers that always want us to price match with walmart. They don't understand when we tell that them that we can't always price match.

K2 said...

And Kroger too! $4 generics AND $25 for every transfer. They think it breeds loyalty, well, not if every other pharmacy in town is doing it too. We've filled rxs where we're the 4th store to get that rx transferred. Then 2 techs get corporate-ly interrogated for giving someone 14 x $25...well, they did transfer them. It's crap.

Vickie said...

Hey! We need to do something about this. You can actually submit comments to the FTC directly via http://www.pbmwatch.com/ and it only takes a few minutes! I did it for the sake of pharmacy. Spread the word.

Anonymous said...

In Connecticut, we have multiple dilemmas. The Walgreens next door to my independent store will be shooting all the express scripts patients my way, which is good business for me...but at the same time, CVS/Caremark is limiting all CT State employees (a LOT of patients) to getting their rxes filled at CVS or mail-order. The only reason I can [barely] afford express-scripts' reimbursement rates is because I dont have the corporate overheard walgreens does, so there's less budget drain from payroll.

Anonymous said...

Unfortunately I work at a walmart pharmacy but I completely agree that our $4/$10 generic list is crap.

Andrea said...

I hated dealing with express scripts to get my prescriptions. They have some trained technicians, but half the time I felt like I was talking to an incompetent child. They also regularly sent more than one three month supply at a time of my nuvaring, which would be fine if nuvaring didn't expire. They wouldn't take back the second unopened package they sent me and refused to take the charge off of my account. I do not believe a regular pharmacy could get away with improperly dispensing their prescriptions.

Chris said...

This is why I've just developed a new appreciation for the NHS! It's not perfect by any stretch of the imagination, but the pricing rules seem to be better.