CVS Health forcing pharmacies to also stop selling cigarettes

[farmadiazepine]

So,

CVS Health is "encouraging" (but realistically forcing) other pharmacies who fill medications for Caremark insured members to stop selling cigarettes and tobacco products, otherwise Caremark members will have to pay a $15 higher copay per prescriptions at the pharmacy than if they went to a pharmacy that does not sell cigarettes and tobacco products.

So if my pharmacy continues to sell cigarettes and tobacco products, and I have Caremark members continue to come to me, the members' copay is going to be $15 higher per prescription than it would be if they went to CVS or another pharmacy that does not sell cigarettes.

How is this even legal? CVS just stopped selling cigarettes and tobacco products only a month ago, and now they are twisting the arms of every other pharmacy to stop selling cigarettes, too, by telling them that their customers will have to pay more for their medications if they fill there?

If CVS Health decides they don't like balloons anymore, and all CVS stores stop selling balloons, now Caremark can tell their members that the member has to pay more money per prescription if the member decides to go to a pharmacy that does sell balloons? Otherwise the pharmacy has to stop sales of balloons just to keep the Caremark members copay to be the same as if the member went to a CVS/pharmacy?

WTF!?!? F*ck you CVS. F*ck you.

We really have to do something about this and this f*cking devil of a company.

CVS is indirectly dictating (although they will say there are "encouraging") what other pharmacies can and cannot sell. Isn't this illegal?

---

Members don't see this ad.

 

[PharFromNormal]

Source? Sounds like a health plan would have to opt in to this, not something they could do on their own.

 

[owlegrad]

Eh, the problem is CVS has the court of public opinion on its side in the 'war' on tobacco. I doubt there will be much public outrage at CVS trying to make health care companies act like they are in the business of keeping people healthy. Wither it is truly an altruistic desire or not (I am sure we all have our own opinions on that), the public perception is that CVS is championing the cause of smoking cessation.

 

[zelman]

Source? Sounds like a health plan would have to opt in to this, not something they could do on their own.

Google news says: "Your search - caremark raise copay - did not match any news results."

 

[BidingMyTime]

I'm not sure this would work, how would CVS Caremark know if Joe Anon's Independent pharmacy is selling cigarettes? Are they going to send a rep to check out every pharmacy? Also, what about a corporation that owns other businesses that sell cigarettes, as well as stand-alone pharmacies that do not sell cigarettes? Would CVS charge the higher co-pay?
Honestly, I'm not a lawyer, but I suspect there are some anti-trust concerns with CVS charging higher co-pays to customers who use non-CVS pharmacies.

 

[confettiflyer]

I want a source or I call BS.

If you own an independent and your tobacco sales are really that high, you can always incorporate a separate but wholly owned subsidiary that leases space within your store to sell tobacco products. Problem solved.

 

[PhilliePharmer]

It's legit...
http://www.ipagroup.org/site/images/tpu100914.pdf

 

[zelman]

It's legit...
http://www.ipagroup.org/site/images/tpu100914.pdf

This is crazypants. Well, it seems to only affect some plans and the link mentions medicare specifically, so we'll see if commercial plans are involved at all when this happens. I foresee lots of bad PR for CVS for this one.

 

[Promethean]

I'm not sure of the legality of it, and it will be interesting to watch it play out. But it does raise the question:

How can a pharmacist sell cigarettes in good conscience? Just because it is legal? You know the harm associated with tobacco products. You see the patients who have been terribly injured by this addiction, coming to you for pills to try to mitigate the effects of the habit. How was this ever acceptable?

I think in a generation or two, this will be viewed similarly to the dispensing of Bayer's wonderdrug Heroin. CVS isn't more moral than anyone else... they can just read the wind better than most.

 

[PharFromNormal]

Ahh as I predicted a plan would have to opt into this for their members.

Contrary to other responses I don't this caremark announcement is specific to medicare, to be frank I think it would only affect commercial plans. That being said if this did affect medicare plans there might be legal concerns as it is a government funded program but with private payors there are much less restrictions on benefit design.

I also don't think this will get as much push back as other tactics utilized by PBMs. Many indys stopped selling tobacco before CVS. If I were an Indy owner across the street from a wags or rite aid, I would love this decision as it would only mean more scripts for me.

 

[297point1]

Okay, I'll play along:

Costs of tobacco-related illness in US: $283 billion (source: http://www.tobaccofreekids.org/facts_issues/toll_us/)
Cost of diabetes-related illness in US: $245 billion (source: http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html)
Costs of alcohol-related illness and injuries in the US: $224 billion (source: http://www.cdc.gov/features/alcoholconsumption/)

Cigarettes are a legal product, just the same as Coca-Cola, Hershey bars, potato chips, and beer. Anyone who has been to a CVS/Wags/RA knows they sell candy, chips, and soda...and Walgreens sells their own private label beer (SDN reviewed it here: http://forums.studentdoctor.net/threads/walgreens-beer.791861/). Junk food and booze cause health problems just the same as tobacco does.

Heck, we all know melanoma is bad and costly...yet this product still appears on shelves: http://www.cvs.com/shop/product-detail/Coppertone-Sun-Screen-Lotion-Spf8?skuId=655035

I understand what they are saying they are trying to do, but the cynic in me sees a wolf in sheep's clothing.

 

[Old Timer]

Okay, I'll play along:

Costs of tobacco-related illness in US: $283 billion (source: http://www.tobaccofreekids.org/facts_issues/toll_us/)
Cost of diabetes-related illness in US: $245 billion (source: http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html)
Costs of alcohol-related illness and injuries in the US: $224 billion (source: http://www.cdc.gov/features/alcoholconsumption/)

Cigarettes are a legal product, just the same as Coca-Cola, Hershey bars, potato chips, and beer. Anyone who has been to a CVS/Wags/RA knows they sell candy, chips, and soda...and Walgreens sells their own private label beer (SDN reviewed it here: http://forums.studentdoctor.net/threads/walgreens-beer.791861/). Junk food and booze cause health problems just the same as tobacco does.

Heck, we all know melanoma is bad and costly...yet this product still appears on shelves: http://www.cvs.com/shop/product-detail/Coppertone-Sun-Screen-Lotion-Spf8?skuId=655035

I understand what they are saying they are trying to do, but the cynic in me sees a wolf in sheep's clothing.

An occasional soda or candy bar will not cause diabetes. There is no amount of tobacco that is not harmful. It's a false comparison. You can't compare my 100 bottle wine cellar with smoking cigarettes. Soda alone is not the cause of diabetes, it's the fact we have sold out to big food. So nice try, but is does not pass teh BS test.

Also, you would better off blaming the environmentalists for ethanol in gasoline as contributing factor to our diabetes epidemic. If you don't know why you don't know jack about the subject.

 

[KidPharmD]

This is another (albeit better disguised) attempt to push Caremark customers toward a CVS.

The first attempt was when Caremark stated that after so many fills that you had to go mail-order (which so many insurances do), but you could get all of your mail order benefits from a CVS store. They tried to bill this as a benefit (you can still use a real pharmacy), but people just saw it as being made to go to CVS.

This will have one of two effects. First, people will start going to CVS to save $15 because their Walgreen's still sells tobacco. Alternatively, it will force the other major pharmacies to get rid of Tobacco products as well, which will lessen their advantage of "product selection" against CVS. In this scenario, CVS looks like the hero in the war on Tobacco.

The problem with option 2 is that I can't see the grocery stores (or Wal-mart) giving up their ability to sell Tobacco products, so at most it will only work on Rite-Aid and Walgreen's.

 

[PharFromNormal]

Im still waiting on you smart people to understand CVS/caremarks customer is different than CVS/pharmacy's customer.

A plan benefit design is a product caremark offers to their customer (i.e. A health plan, employer, benefits group etc). There are few things caremark can implement on their own that these customers can't choose. The health plans that opt into these things (mail order only, how restrictive the formulary is, limited networks, copay penalty on tobacco locations etc.) all made active decisions that is made by the customer purchasing the services from caremark. There are no barriers caremark is implementing or enforcing that prevents other locations in reducing their customer's copay by ceasing to sell tobacco if they currently are.

 

[Ackj]

Honestly, I'm not a lawyer, but I suspect there are some anti-trust concerns with CVS charging higher co-pays to customers who use non-CVS pharmacies.

Doesn't Caremark already do that? I know I've lost customers who could only get refills at a CVS, any other pharmacy is not covered.

 

[297point1]

An occasional soda or candy bar will not cause diabetes. There is no amount of tobacco that is not harmful. It's a false comparison. You can't compare my 100 bottle wine cellar with smoking cigarettes. Soda alone is not the cause of diabetes, it's the fact we have sold out to big food. So nice try, but is does not pass teh BS test.

I am well aware of Big Food...Michael Pollan always offers enlightening and entertaining reads.

I think you missed my point (actually I am certain of it): it doesn't matter that you think soda and candy is reasonable and not harmful in moderation; a corporate entity with the ability to move markets in a significant manner is now making that decision. They started with tobacco, and at some point in the future might make that decision for sweets as well. This is a slippery slope...and it does not involve an activist mayor who is term limited and/or can be voted out of office (see: Michael Bloomberg's attempts to ban Big Gulps).

Also, you would better off blaming the environmentalists for ethanol in gasoline as contributing factor to our diabetes epidemic. If you don't know why you don't know jack about the subject.

Increased corn demand for conversion to ethanol = rise in corn prices = rise in high fructose corn syrup prices = rise in high-calorie carbonated soda prices = drop in high-calorie carbonated soda demand [and consumption]. Win/win.

 

[zelman]

I'm not sure of the legality of it, and it will be interesting to watch it play out. But it does raise the question:

How can a pharmacist sell cigarettes in good conscience? Just because it is legal? You know the harm associated with tobacco products. You see the patients who have been terribly injured by this addiction, coming to you for pills to try to mitigate the effects of the habit. How was this ever acceptable?

Cigarettes decrease symptoms of ulcerative colitis. Until there is a prescription alternative, tobacco sales help support your UC patients.

As for the remaining 99% of the population, you're mostly right. Pharmacist owned stores shouldn't offer tobacco. Unfortunately, many locations that offer pharmacy services are not owned by healthcare practitioners, and often don't even own the pharmacy itself. Just because they rent space to another company does not mean they share the same values.

 

[KidPharmD]

Im still waiting on you smart people to understand CVS/caremarks customer is different than CVS/pharmacy's customer.

A plan benefit design is a product caremark offers to their customer (i.e. A health plan, employer, benefits group etc). There are few things caremark can implement on their own that these customers can't choose. The health plans that opt into these things (mail order only, how restrictive the formulary is, limited networks, copay penalty on tobacco locations etc.) all made active decisions that is made by the customer purchasing the services from caremark. There are no barriers caremark is implementing or enforcing that prevents other locations in reducing their customer's copay by ceasing to sell tobacco if they currently are.

Except... That in your discussion, the customer (Caremark calls them clients) are the corporations buying Caremark insurance for their employees. Those clients are also highly motivated to save money on health insurance and are usually willing to accept anything that Caremark (or whatever PBM) can sell them as saving money.

Individual purchasers are only given the choice of what the PBM's are offering as private pay insurance. I expect this feature to show up on a lot of private pay, medicare, and large corporation Caremark plans to have this feature.

The goal of course if for all of CVS/Caremark's members (because the clients are the real customers) to also be CVS/Pharmacy customers.

 

[Old Timer]

Increased corn demand for conversion to ethanol = rise in corn prices = rise in high fructose corn syrup prices = rise in high-calorie carbonated soda prices = drop in high-calorie carbonated soda demand [and consumption]. Win/win.

You don't get it at all. Increased government subsidy for corn means lower corn prices and increased use of HFCS which in my opinion is the main driver of diabetes....

 

[PharFromNormal]

Except... That in your discussion, the customer (Caremark calls them clients) are the corporations buying Caremark insurance for their employees. Those clients are also highly motivated to save money on health insurance and are usually willing to accept anything that Caremark (or whatever PBM) can sell them as saving money.

Individual purchasers are only given the choice of what the PBM's are offering as private pay insurance. I expect this feature to show up on a lot of private pay, medicare, and large corporation Caremark plans to have this feature.

The goal of course if for all of CVS/Caremark's members (because the clients are the real customers) to also be CVS/Pharmacy customers.

You have some half correct statements in here. Yes clients are motivated to opt into whatever is cost-effective for them. If jacking up co-pays will artificially create adherence barriers because their members love their tobacco selling pharmacy so much and don't want to change which leads to increased morbidity/mortality - I don't see them opting in.

Take a close look at this startling article on preferred networks for next year:

http://www.drugchannels.net/2014/10/exclusive-for-2015-almost-9-out-of-10.html

Take a nice little look at Silverscript which as you know is operated by CVS. Why do they have such a large share of open networks if they are trying to drive their members towards CVS pharmacies? Interesting huh?

If there is a market for people who want free choice and they are willing to pay for it a PBM will provide it. I anticipate this to show up on many plans as well, but I also anticipate individual purchasers to have the ability to buy something without this from caremark and if not caremark then other PBMs.

I don't think the goal for cvs/caremark is to have all members cvs/pharmacy members, not saying that they would hate it... but I think they know it's unreasonable to expect.

 

[zelman]

You have some half correct statements in here. Yes clients are motivated to opt into whatever is cost-effective for them. If jacking up co-pays will artificially create adherence barriers because their members love their tobacco selling pharmacy so much and don't want to change which leads to increased morbidity/mortality - I don't see them opting in.

The. Clients. Are. Employers.

They want to offer the cheapest plan to employees. They don't care if employees like the restrictions or die. If a cashier at a grocery store dies, the company itself has next to no concern.

 

[PharFromNormal]

The. Clients. Are. Employers.

They want to offer the cheapest plan to employees. They don't care if employees like the restrictions or die. If a cashier at a grocery store dies, the company itself has next to no concern.

Wow how dense are you? Yes the clients are employers as well as health plans with carve in benefits. You realize once the employee goes into the hospital the employer is going to end up paying a **** ton more when the employee hits catastrophic health coverage.

 

[managedcarepharmd]

The. Clients. Are. Employers.

They want to offer the cheapest plan to employees. They don't care if employees like the restrictions or die. If a cashier at a grocery store dies, the company itself has next to no concern.

Very shortsighted answer from zelman.

You do realize that a PBM contracts with health plans, right? What do health plans worry about? That's right, if they're a Medicare plan, they'll have to play ball with quality metrics, which include Star measures. There are some health plans that worry about adherence so much that they offer $0 copays for certain classes of medications to drive up adherence.

These quality measures are coming to commercial plans as well.

And to refute your asinide comment, have you heard of tech companies in Silicon Valley? Competition is fierce between these tech companies to attract the best employees. If that means offering richer benefits, including drugs, so be it.

 

[zelman]

Very shortsighted answer from zelman.

You do realize that a PBM contracts with health plans, right? What do health plans worry about? That's right, if they're a Medicare plan, they'll have to play ball with quality metrics, which include Star measures. There are some health plans that worry about adherence so much that they offer $0 copays for certain classes of medications to drive up adherence.

These quality measures are coming to commercial plans as well.

And to refute your asinide comment, have you heard of tech companies in Silicon Valley? Competition is fierce between these tech companies to attract the best employees. If that means offering richer benefits, including drugs, so be it.

My answer is intended to represent the shortsightedness of those who will make the decisions.

Not every PBM contract is with a health insurer. You are correct that those that are may see things differently.

Silicon Valley is not representative of anywhere else.

 

[zelman]

Wow how dense are you? Yes the clients are employers as well as health plans with carve in benefits. You realize once the employee goes into the hospital the employer is going to end up paying a **** ton more when the employee hits catastrophic health coverage.

So you think that my employer is charged money when I get a heart transplant (or other equally expensive care)? I was unaware that they would be paying my bills.

 

[PharFromNormal]

So you think that my employer is charged money when I get a heart transplant (or other equally expensive care)? I was unaware that they would be paying my bills.

Wow you clearly don't know how benefits work. Let me try and explain it as basic as I can. When your employer secures a medical benefit from a health insurance company the amount they pay and the amount of your deductible and/or premiums equates to the anticipated cost of services for that population. If your employer has a population that experiences abnormally high heart transplant rates then they would either pay more for your health benefit package or pass more cost onto you through a variety different methods you are probably also unaware of.

 

[pezdispenser]

So you think that my employer is charged money when I get a heart transplant (or other equally expensive care)? I was unaware that they would be paying my bills.

A lot of large companies do actually self-insure for health care benefits for their employees. They may still use a company like United Health or Aetna to administer the plan and get preferred provider networks, but in the end, the employer does pay the bills.

 

[zelman]

Wow you clearly don't know how benefits work. Let me try and explain it as basic as I can. When your employer secures a medical benefit from a health insurance company the amount they pay and the amount of your deductible and/or premiums equates to the anticipated cost of services for that population. If your employer has a population that experiences abnormally high heart transplant rates then they would either pay more for your health benefit package or pass more cost onto you through a variety different methods you are probably also unaware of.

If people who understood healthcare made decisions in business, the correctness of your point would matter. If people who would kill a few employees to raise stock prices by $1 were making those decisions, we'd be dealing in reality.

 

[zelman]

A lot of large companies do actually self-insure for health care benefits for their employees. They may still use a company like United Health or Aetna to administer the plan and get preferred provider networks, but in the end, the employer does pay the bills.

I would think self-insuring companies would be making their own policies regardless of any silly fad plan tweaks CVS Health invents.

 

[PharFromNormal]

If people who understood healthcare made decisions in business, the correctness of your point would matter. If people who would kill a few employees to raise stock prices by $1 were making those decisions, we'd be dealing in reality.

I think the reality is people that understand the levers of their business understand that how they manage the health benefits that they choose to provide as an option to their employees matters. Perhaps you should think of the negative PR and suits a company would face if they were responsible for killing their employees. That would probably cost a whole lot more than providing normal adequate benefits.

 

[PharFromNormal]

I would think self-insuring companies would be making their own policies regardless of any silly fad plan tweaks CVS Health invents.

They do.... They have to choose to opt into this silly fad plan tweak that CVS Health is offering.

 

[kvl1027]

This is going to require individual state legislation to beat. It would be nice if there was a strong pharmacy association that could help lobby. I'm studying for Maryland Law now and there is a section that prohibits a difference in co-pay based on which pharmacy fills the prescription. That's the kind of verbiage every state needs.

 

[ChalupaBatman86]

I don't believe it is legit. Never heard of "IPA" and they don't state the source of their information. Anybody can print a memo.

 

[pezdispenser]

I would think self-insuring companies would be making their own policies regardless of any silly fad plan tweaks CVS Health invents.

Sure. I think even companies that don't self-insure still get to choose a lot of the parameters of their health plan.

Actually if a plan sponsor or insurer wants to provide a disincentive to smoking, all they need to do is raise the premiums for smokers. This dings smokers directly, and does not affect non-smokers. My employer charges $600 more if you smoke.

But raising copays at pharmacies that sell tobacco is kind of stupid, because then non-smokers will get dinged as well. A non-smoker could be using a particular pharmacy for reasons totally irrespective of tobacco, because obviously they are not buying tobacco anyway. But with the Caremark plan, these non-smokers will get dinged $15 on each prescription as well? This penalty is totally misdirected.

 

[Aznfarmerboi]

You guys are getting riled up over something that may or may not be true. There is no news of this.

Plus, Caremark members do have a choice to go to CVS pharmacy for refills on their maintenance medications instead of doing mail order. It is no different than insurance companies forcing their members to fill via mail order. Members can still choose to go to their regular pharmacies... and get mail order. If they don't like that option, their employers can pay more for no mail order.

How is this a thing to complain about...? ... don't hate because it is a brilliant move for CVS to drive synergy.

 

[farmadiazepine]

http://www.ipagroup.org/site/images/tpu100914.pdf#sthash.8MB09yUe.dpuf

 

[Aznfarmerboi]

http://www.ipagroup.org/site/images/tpu100914.pdf#sthash.8MB09yUe.dpuf

That is crazy. It will be interesting to see how this plays out.

 

[BMBiology]

CVS stock is up 1% so far:

http://m.wsj.com/articles/BL-270B-850

 

[BF7]

This is going to require individual state legislation to beat. It would be nice if there was a strong pharmacy association that could help lobby. I'm studying for Maryland Law now and there is a section that prohibits a difference in co-pay based on which pharmacy fills the prescription. That's the kind of verbiage every state needs.

Here in texas we have an " any willing provider" provision that is repeatedly violated by PBMs forcing patients into mail order or preferred pharmacies. It was enacted in 1991 but courts continually create exceptions which has made this " rule" virtually unenforceable and continually snickered at by the PBMs

http://www.healthplanlaw.com/?p=222

 

[BF7]

Sure. I think even companies that don't self-insure still get to choose a lot of the parameters of their health plan.

Actually if a plan sponsor or insurer wants to provide a disincentive to smoking, all they need to do is raise the premiums for smokers. This dings smokers directly, and does not affect non-smokers. My employer charges $600 more if you smoke.

But raising copays at pharmacies that sell tobacco is kind of stupid, because then non-smokers will get dinged as well. A non-smoker could be using a particular pharmacy for reasons totally irrespective of tobacco, because obviously they are not buying tobacco anyway. But with the Caremark plan, these non-smokers will get dinged $15 on each prescription as well? This penalty is totally misdirected.

Stupid indeed. I don't sell tobacco products ... But I do sell candy and soft drinks. What's next for these INSURANCE companies to dictate to a private business? PBMs sole purpose should be as a financial pass through...our profession is under attack by these organizations no doubt about it.

 

[Old Timer]

Stupid indeed. I don't sell tobacco products ... But I do sell candy and soft drinks. What's next for these INSURANCE companies to dictate to a private business? PBMs sole purpose should be as a financial pass through...our profession is under attack by these organizations no doubt about it.

And has been since the 1980's. That's when indies had the leverage to do something about. They were so short sighted since it was such small portion of the business they figured what the heck. Then there was always some a-hole that signed everything to get more volume....

 

[KidPharmD]

This policy doesn't seem violate "Any willing provider" laws. Most of those laws do not seem to dictate the ability of the PBM's to set ridiculous terms for the contract. Besides, under this policy, the pharmacy is actually paid the same (theoretically) for a drug if they are a tobacco or non tobacco store. It only changes how much the patient is responsible for.

 

[PharFromNormal]

This policy doesn't seem violate "Any willing provider" laws. Most of those laws do not seem to dictate the ability of the PBM's to set ridiculous terms for the contract. Besides, under this policy, the pharmacy is actually paid the same (theoretically) for a drug if they are a tobacco or non tobacco store. It only changes how much the patient is responsible for.

This is half true. The pharmacy is being reimbursed different amounts from the payor, this is the part that matters. Forcing the patient to pay the additional cost is a crime for those wishing to try an adopt any willing provider for pharmacies. Side note: pharmacists aren't providers lol.

The counter here is this would satisfy any willing provider as any pharmacy willing to remove tobacco (this is the terms of the contract) would enjoy the benefits of the contracted rate. Indys and small chains who use any willing provider for preferred network arguements always say they are willing to accept the lower contracted rate that the preferred players have they just don't have a seat at the table. This is inherently different.

 

[BF7]

This policy doesn't seem violate "Any willing provider" laws. Most of those laws do not seem to dictate the ability of the PBM's to set ridiculous terms for the contract. Besides, under this policy, the pharmacy is actually paid the same (theoretically) for a drug if they are a tobacco or non tobacco store. It only changes how much the patient is responsible for.

i was not referring to this ridiculous tobacco policy and it's relevanceto 'AWP'.. I was making a segue into other market altering policies of PBMs that are relevant to the 'AWP' statutes that some states have in force.( mandatory mail order, copay incentives)

Here's an article about a pharmacy in Maine that is successfully utilizing their state's 'AWP' legislation to maintain access to patients who prefer to utilize them.

Maine law requires that any certified pharmacy willing to meet an insurer’s terms can fill a prescription.

“That’s not true in a lot of other states,” McAuliffe said. “We’re not afraid of competing against mail-order pharmacies, we are afraid of not being allowed to compete.”



https://bangordailynews.com/2014/10...thrives-in-specialty-medication-market/print/

 

[fewaopi]

pretty sure this is legit, got an alert from seeking alpha about this. seems like restraint of trade and some legal issues with this but I know CVS pretty much can violate almost any law it chooses. it did already with forcing people to CVS mail order, it'd doing that again with charging higher copays for patients going to pharmacies selling cigarettes.

pharmacists know CVS for what it really is. but the public is really ******ed, you have no idea how many people said they'll transfer to CVS because they stopped cigarettes.
and then what about the alcohol sales? or junk food? 1 won't kill you like cigarettes, should do the same there too no?

i'm confident CVS can get away with this though. it's good politics and money talks. a DM i know said that rite aid once couldn't buy a smaller chain because of anti-trust laws. but cvs came in and bought the small chain. why? because CVS can pay more to the politicians' bank account, simple, CVS had more bribing money. i'm sure CVS can do the same here. and once CVS becomes a monopoly, all the clueless Americans will wonder why their prices just skyrocketed. all the same. cvs seems like the only retail choice for grads in the future, especially when there are fewer and fewer openings.

 

[ChalupaBatman86]

Yeah, it's real. I was wrong. Seems crazy even by CVS standards.

 

[Aznfarmerboi]

Cvs already signed on contracts with employers like Philadelphia so it is happening.

This is crazy and definitely something I have not seen before. I dont care about Rite Aid and Walgreens because they should stop selling cigarettes.

I am worried about independents... and how people might just go to CVS because it is easier.

 

[zelman]

Can independents start selling cigarette cartons and giving away the tobacco inside for free?

 

[Sparda29]

Cvs already signed on contracts with employers like Philadelphia so it is happening.

This is crazy and definitely something I have not seen before. I dont care about Rite Aid and Walgreens because they should stop selling cigarettes.

I am worried about independents... and how people might just go to CVS because it is easier.

Independents where I work don't sell cigarettes. The one where I work full-time is mainly compounding. We stock the basic regular rx items in case someone brings in a script occasionally. But most of the money made is on dermatology compounds. There's a dermatologist in the area who loves the desonide/tretinoin/hydroquinone and clindamycin/tretinoin/hydroquinone compounds we make and just faxes the scripts to us. We either deliver it to his office where he will give it to the patient or we'll have our delivery guy bring it to their home.

 

[kvl1027]

Here in texas we have an " any willing provider" provision that is repeatedly violated by PBMs forcing patients into mail order or preferred pharmacies. It was enacted in 1991 but courts continually create exceptions which has made this " rule" virtually unenforceable and continually snickered at by the PBMs

http://www.healthplanlaw.com/?p=222

There's always some Bull**** with these PBMs!!!!! They drive me bat**** crazy!