Express Scripts / Medco merger completed

[All4MyDaughter]

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I agree with a lot of what MountainDude says. A lot of PA requests are likely bogus. Why does someone need to start with Nexium for heartburn? What's wrong with generic omeprazole? No, Edarbi is not first line therapy for a patient with new hypertension. And so on.

 

[meister]

patients ask for these medications and doctors give in to them because it's good business, though it's bad medicine

 

[All4MyDaughter]

patients ask for these medications and doctors give in to them because it's good business, though it's bad medicine

Or physicians write for them b/c they are influenced by drug reps.

If patients want to pay cash for these meds, who cares? But expecting the insurance company to? I think step therapy and starting with less costly agents is reasonable, and good policy.

 

[rxlea]

Or physicians write for them b/c they are influenced by drug reps.

If patients want to pay cash for these meds, who cares? But expecting the insurance company to? I think step therapy and starting with less costly agents is reasonable, and good policy.

Agreed.👍

 

[xtsukiyox]

Or physicians write for them b/c they are influenced by drug reps.

If patients want to pay cash for these meds, who cares? But expecting the insurance company to? I think step therapy and starting with less costly agents is reasonable, and good policy.

I didn't really understand the reasons behind step therapy & prior auths before my s/o worked in a call center type position taking prior auth calls for a state-funded insurance contract. I've heard it said that physicians prescribe the same 10 drugs 80 percent of the time (specifically which 10 drugs depends on the physician). With so many pharmaceutical treatments, physicians shouldn't be expected to know everything about them! Unfortunately, pride tends to dictate action in this arena more often than it should. When managing limited resources, optimizing with a standardized process does make sense. It's not like there isn't also a way to get an exception if the physician feels it is warranted.

That doesn't mean that step therapy & prior auths aren't a huge pain for everyone involved (except Mountain). That also doesn't mean I think PBMs warrant the size of their piece of the pie...

 

[WVUPharm2007]

I had a PBM pharmacist once insist that albuterol was a maintenance drug and, thus, needed to be mail ordered.

I've always assumed they are all idiots.

Though I must admit, listening to the crack pot reasons physicians probably come up with to bypass formularies would be a fun job.

Not as fun as seeing the line of crackheads queue up at 12:01 for their oxycodone on the first of the month...but still a devilish, laugh at the stupid humans sort of fun.

 

[StevePerry]

It is less dark then it used to be. 😉

I too love the "new" mountain. 🙂

I miss the old, non-gentrified Mountain... no one else on here has that 24/7 venomous attitude combined with intelligence anymore. Sure someone might get angry and have a rant or two, or some dumb pre-pharm might have a bad attitude, but its just not the same...

 

[StevePerry]

Or physicians write for them b/c they are influenced by drug reps.

If patients want to pay cash for these meds, who cares? But expecting the insurance company to? I think step therapy and starting with less costly agents is reasonable, and good policy.

Thats the good part of what PBM's do from society's perspective and ours because that means patients can be on more drugs (better for us -- more jobs for pharmacists) for the same price to the patient. In the PBM-Drug Company-Pharmacy Triangle I'd rather have the PBM's going after the drug companies and not pissing all over anything that resembles a pharmacy, but we all know they don't care how they make their profit, of which no one can justify the % they claim for playing middleman. When you look at all the bull---- barriers to entry enacted in the insurance industry, you can get the gist that no one gives a hot ---- about saving money for sponsors, patients, society, etc...

 

[farmadiazepine]

All I want is for the DUR reject codes and overrides to be the same with the merger. All I want to do is be able to M0 3D 2 2 all high does and be able to #3 vacation supply all refill too soon rejects.

Medco insurance has been awesome in terms of RPh overrides but Express has been the biggest b*i*tC*h in terms of PBMs. I cringe when I see 3858 hoping I wont get a reject bc of this dumb pbm.

For customer service, working at CVS, Medco is awesome insurance to have in terms of overrides, but sucks as bc alot of meds require prior auths or have plan limitations. Express is the worst...

O well, regardless, the patient, or as I like to call them "the customer" is going to suffer, not me. I'm still getting paid the same lol

 

[angelflower1346]

Why do you think that there are going to be more jobs for pharmacists? Once the mail order companies take over. Many of the drugstore chains will be forced to close down causing mass amounts of pharmacist jobs to be lost.

 

[StevePerry]

Why do you think that there are going to be more jobs for pharmacists? Once the mail order companies take over. Many of the drugstore chains will be forced to close down causing mass amounts of pharmacist jobs to be lost.

Thanks for joining just to post that and break new ground on the discussion board.

 

[297point1]

Why do you think that there are going to be more jobs for pharmacists? Once the mail order companies take over. Many of the drugstore chains will be forced to close down causing mass amounts of pharmacist jobs to be lost.

Yeah- so much so that Medco decided to help open up a new pharmacy school...

I suspect the name will be changing soon!

 

[Ackj]

No, Edarbi is not first line therapy for a patient with new hypertension. And so on.

Went to a dinner the other night about Edarbi. It's the cheapest brand-name ARB, and has (minimally) better data in a head to head with Diovan and Benicar. First line? No, but this "me-too" actually has something going for it. So if you're an ACE-cougher and don't respond adequately to losartan, then I guess it can be your 3rd line.

 

[Avelox]

Except Diovan and a bunch of other ARBs are going generic in '12 too 🙂

 

[owlegrad]

Except Diovan and a bunch of other ARBs are going generic in '12 too 🙂

Drat, I was JUST about to say this. Well played sir. 😉

 

[TonyRx]

Thanks for joining just to post that and break new ground on the discussion board.

👍

 

[Redheadedpharm]

I think you can count on a few things now that the Medco/Express Scripts merger is complete.

1. Further PBM consolidation. This was almost inevitable after the merger was approved by the FTC. Actually, you are already seeing the beginnings of further consolidation within the PBM industry with the announcement of the SXC and Catalyst Rx deal. Sure that is on a whole different level than the likes of Medco and Express Scripts, but it is only the beginning.

http://www.chicagobusiness.com/arti...fits-firm-sxc-in-4-4-billion-deal-stock-jumps

2. Walgreens will renegotiate with the new Express Scripts Holding Co. Walgreens took a stand when they said no to Express Scripts. And they lost business because of it. When they let ESI go, other companies tried to take that business instead of following the lead of Walgreens. When the current Medco deal expires, expect the two companies to come to a new agreement. They may even try to barter a preferred provider status. Who knows? Anything is possible these days.

3. PBMs will flex their muscles. Even more than the current prescription contracts, the next wave of deals that PBMs will offer pharmacies will probably give us less money per prescription we fill. The PBMs will also continue to create preferred provider networks forcing patients into using a certain chain or mail order for maintenance prescriptions or only offering 90 days supply options at certain locations. They will also try to bargain their way to deep discounts on brand-named medications which may result in branded drugs being preferred more often even over generics.

4. New retail pharmacy models coming. In response to a business that just doesn't pay anything anymore, the big players in retail pharmacy like Walgreens will continue to experiment with alternative retail pharmacy business models that will save them labor costs and reduce their dependency on retail pharmacists. Central fill, remote counseling, tech-check-tech, and a whole lot of other options will all be considered. This is their answer to terrible reimbursement rates instead of fighting the PBMs directly.

5. Renegotiation of salaries of pharmacists. If the supply/demand equation remains in heavy favor of an abundance of pharmacists for the forseeable future, expect Walgreens and other employers to start a downward trend with pharmacist salaries. They know they can find someone who will do whatever they ask, so they will start freezing raises or worse, cutting salaries.


I realize all of this sounds bleak. Unfortunately, it also sounds plausible. The next few years is a very critical time for the profession of pharmacy and for retail specifically. What happens in the next 18-36 months may impact pharmacists for decades to come. I just hope some of the change coming will be positive.

 

[297point1]

Seems like some individuals and trade groups are still trying to block this merger, to no success:
http://www.chicagotribune.com/busin...-derail-medco-merger-20120425,0,7267358.story

I'm all for fighting the good fight, but this is not going to be stopped...Pandora's box has been opened- there's no closing it now!

 

[297point1]

Two different experts at last week's Academy of Managed Care Pharmacy's Annual Meeting identified the Express Scripts-Medco merger as the "news item of the year" in managed care for 2011.

One of those two already proclaimed that the merger will be the "news item of the year" for 2012...

The Walgreens-Express Scripts dispute was also in the top 5 for both of their lists.

 

[Ilikechemicals]

I think you can count on a few things now that the Medco/Express Scripts merger is complete.

1. Further PBM consolidation. This was almost inevitable after the merger was approved by the FTC. Actually, you are already seeing the beginnings of further consolidation within the PBM industry with the announcement of the SXC and Catalyst Rx deal. Sure that is on a whole different level than the likes of Medco and Express Scripts, but it is only the beginning.

http://www.chicagobusiness.com/arti...fits-firm-sxc-in-4-4-billion-deal-stock-jumps

2. Walgreens will renegotiate with the new Express Scripts Holding Co. Walgreens took a stand when they said no to Express Scripts. And they lost business because of it. When they let ESI go, other companies tried to take that business instead of following the lead of Walgreens. When the current Medco deal expires, expect the two companies to come to a new agreement. They may even try to barter a preferred provider status. Who knows? Anything is possible these days.

3. PBMs will flex their muscles. Even more than the current prescription contracts, the next wave of deals that PBMs will offer pharmacies will probably give us less money per prescription we fill. The PBMs will also continue to create preferred provider networks forcing patients into using a certain chain or mail order for maintenance prescriptions or only offering 90 days supply options at certain locations. They will also try to bargain their way to deep discounts on brand-named medications which may result in branded drugs being preferred more often even over generics.

4. New retail pharmacy models coming. In response to a business that just doesn't pay anything anymore, the big players in retail pharmacy like Walgreens will continue to experiment with alternative retail pharmacy business models that will save them labor costs and reduce their dependency on retail pharmacists. Central fill, remote counseling, tech-check-tech, and a whole lot of other options will all be considered. This is their answer to terrible reimbursement rates instead of fighting the PBMs directly.

5. Renegotiation of salaries of pharmacists. If the supply/demand equation remains in heavy favor of an abundance of pharmacists for the forseeable future, expect Walgreens and other employers to start a downward trend with pharmacist salaries. They know they can find someone who will do whatever they ask, so they will start freezing raises or worse, cutting salaries.


I realize all of this sounds bleak. Unfortunately, it also sounds plausible. The next few years is a very critical time for the profession of pharmacy and for retail specifically. What happens in the next 18-36 months may impact pharmacists for decades to come. I just hope some of the change coming will be positive.

The writing is on the wall. I jumped from retail to a pbm a few months back. Retail pharmacy has no where left to go.

All the things Walgreens proposes that the "new" pharmacist can do is stuff a NP can do for about 2/3rds the pay. Once they get the pharmacist out of the pharmacy its just a matter of time until they convince BOPs they dont need a pharmacist onsite. Either that or the retail pharmacist salary will be brought down to a NP level.

 

[UConn101]

The writing is on the wall. I jumped from retail to a pbm a few months back. Retail pharmacy has no where left to go.

All the things Walgreens proposes that the "new" pharmacist can do is stuff a NP can do for about 2/3rds the pay. Once they get the pharmacist out of the pharmacy its just a matter of time until they convince BOPs they dont need a pharmacist onsite. Either that or the retail pharmacist salary will be brought down to a NP level.

Nice, I've been thinking about making the jump to PBM as well!

What kind of function are you working as at the PBM? I know it requires a different mentality than retail in terms of project management....what is your advice? Is a residency required?

What is your position, how is the job market? Thanks so much!

 

[StreetFarmercy]

Two different experts at last week's Academy of Managed Care Pharmacy's Annual Meeting identified the Express Scripts-Medco merger as the "news item of the year" in managed care for 2011.

One of those two already proclaimed that the merger will be the "news item of the year" for 2012...

The Walgreens-Express Scripts dispute was also in the top 5 for both of their lists.

How'd you enjoy the conference?

 

[UConn101]

Two different experts at last week's Academy of Managed Care Pharmacy's Annual Meeting identified the Express Scripts-Medco merger as the "news item of the year" in managed care for 2011.

One of those two already proclaimed that the merger will be the "news item of the year" for 2012...

The Walgreens-Express Scripts dispute was also in the top 5 for both of their lists.

Hey 297, I noticed you used to work for the PBM side.

How'd you like it? Was it pleasant? How's it compare to academia?

I'm thinking about applying for a job there...were you able to get a job at the PBM without a residency?

What was your normal day like?

Thank you!

 

[Ilikechemicals]

Nice, I've been thinking about making the jump to PBM as well!

What kind of function are you working as at the PBM? I know it requires a different mentality than retail in terms of project management....what is your advice? Is a residency required?

What is your position, how is the job market? Thanks so much!

No residency is required. At least for the vast majority of positions. I work in a "triage" area. Basically we contact MD's (usually by fax) or patients to clarify things on problem orders. It ranges from state law requirements to clinical stuff. It's pretty sweet job cause you get exposed to some weird drugs and there is always something new to learn/see.

However, if you work the verification area I would imagine you would go insane. They expect you to verify A LOT of scripts per hour. Doing that for 8 hours a day every day would be brutal. All they do is verify and nothing else.

In Dallas/Fort Worth area ESI and Caremark were hiring although I think they might be done now.

 

[Ackj]

No residency is required. At least for the vast majority of positions. I work in a "triage" area. Basically we contact MD's (usually by fax) or patients to clarify things on problem orders. It ranges from state law requirements to clinical stuff. It's pretty sweet job cause you get exposed to some weird drugs and there is always something new to learn/see.

However, if you work the verification area I would imagine you would go insane. They expect you to verify A LOT of scripts per hour. Doing that for 8 hours a day every day would be brutal. All they do is verify and nothing else.

In Dallas/Fort Worth area ESI and Caremark were hiring although I think they might be done now.

Verification as a PBM? Is that just mail order rx verification, or is there some kind of verification that goes on after a pharmacy submits a claim to the PBM?

 

[rxlea]

Do you guys think MountainPharmD is happy? He hasn't come around...if he doesn't have CVS to complain about, he may be lost forever. Sad.

 

[MountainPharmD]

No residency is required. At least for the vast majority of positions. I work in a "triage" area. Basically we contact MD's (usually by fax) or patients to clarify things on problem orders. It ranges from state law requirements to clinical stuff. It's pretty sweet job cause you get exposed to some weird drugs and there is always something new to learn/see.

However, if you work the verification area I would imagine you would go insane. They expect you to verify A LOT of scripts per hour. Doing that for 8 hours a day every day would be brutal. All they do is verify and nothing else.

In Dallas/Fort Worth area ESI and Caremark were hiring although I think they might be done now.

One more pharmacist position to fill and they tell me that will be it for quite some time.

 

[rxlea]

One more pharmacist position to fill and they tell me that will be it for quite some time.

are you happy at your new job mountain?

 

[MountainPharmD]

are you happy at your new job mountain?

I am so happy I'll need plastic surgery to remove the smile from my face! I have truly been blessed with some good fortune this year. I don't know what I did to deserve it and I not asking any questions!

To further validate my decision I had to stop by my old pharmacy today and pick up some stuff I left. As my old partner is telling me how much worse things have gotten since I left the phone is ringing off the hook and the drive through bell is going off and a tech called in sick. I got out of there as fast as I could.

 

[rxlea]

I am so happy I'll need plastic surgery to remove the smile from my face! I have truly been blessed with some good fortune this year. I don't know what I did to deserve it and I not asking any questions!

To further validate my decision I had to stop by my old pharmacy today and pick up some stuff I left. As my old partner is telling me how much worse things have gotten since I left the phone is ringing off the hook and the drive through bell is going off and a tech called in sick. I got out of there as fast as I could.

That's great. I'm very happy for you. Congrats on the new position 🙂

 

[MountainPharmD]

That's great. I'm very happy for you. Congrats on the new position 🙂

Thanks!

I check in on here just as much as I always did. It seems i am doing more reading than posting since I got the new job. I am still getting used to the new job and don't want to come on here and be that annoying guy that does nothing but post how great his job is. Plus I have a rep to protect. I am Mr. Negative doom and gloom guy. I have to be careful or people might think I have changed.

Here is for old times sake....CVS SUCKS!!!! Yeah!!!!

 

[UConn101]

No residency is required. At least for the vast majority of positions. I work in a "triage" area. Basically we contact MD's (usually by fax) or patients to clarify things on problem orders. It ranges from state law requirements to clinical stuff. It's pretty sweet job cause you get exposed to some weird drugs and there is always something new to learn/see.

However, if you work the verification area I would imagine you would go insane. They expect you to verify A LOT of scripts per hour. Doing that for 8 hours a day every day would be brutal. All they do is verify and nothing else.

In Dallas/Fort Worth area ESI and Caremark were hiring although I think they might be done now.

Thanks for the answer! How was the pay relative to a retail/pharmacy position?

 

[UConn101]

Thanks!

I check in on here just as much as I always did. It seems i am doing more reading than posting since I got the new job. I am still getting used to the new job and don't want to come on here and be that annoying guy that does nothing but post how great his job is. Plus I have a rep to protect. I am Mr. Negative doom and gloom guy. I have to be careful or people might think I have changed.

Here is for old times sake....CVS SUCKS!!!! Yeah!!!!

Hi MountainPharmD, what department of the PBM do you work under?

How did you find the job, is it regional or a natioanl company?

Also, what kind of traits/characteristics would help with getting into the PBM side? Is retail really doomed?

Thank you!!!

 

[MountainPharmD]

Hi MountainPharmD, what department of the PBM do you work under?

How did you find the job, is it regional or a natioanl company?

Also, what kind of traits/characteristics would help with getting into the PBM side? Is retail really doomed?

Thank you!!!

Its not what you know but who you know my friend. Sorry but its the truth. I got very lucky and was at the right place at the right time.

I am in the appeals department. A large portion of my time is spent doing research. All I have to start with most of the time is a letter faxed in from a doctors office. I have to research the member, the claim, the plan specific guidlines, the medication and then relate it all back to the letter. I determine if it makes sense clinically and how it fits into the members plan and then I make a decision. Each one is different and can take me anywhere from 10 minutes to an hour or more to do. There is no emphasis on speed or production or quotas. The emphasis is on quality and doing a complete full and fair review each and every time and getting it right the first time. I am in freaking heaven and I love it!

Yes, retail is doomed. The current business model is unsustainable. There will be big changes soon and they will not be good for the profession.

 

[MountainPharmD]

Thanks for the answer! How was the pay relative to a retail/pharmacy position?

Considerably lower yet still 6 figures. Remember there are many things you gain that are worth more than the pay difference.

 

[UConn101]

Considerably lower yet still 6 figures. Remember there are many things you gain that are worth more than the pay difference.

It's such a niche field, pharm schools pay almost ZERO attention to it...everyone is drinking the "clinical" inpatient Kool-Aid...

Would you recommend your friends/relatives to go to into the PBM side as pharmacists?

How difficult is it to move up within a PBM? I'd imagine easier than retail/hospital...

 

[UConn101]

Its not what you know but who you know my friend. Sorry but its the truth. I got very lucky and was at the right place at the right time.

I am in the appeals department. A large portion of my time is spent doing research. All I have to start with most of the time is a letter faxed in from a doctors office. I have to research the member, the claim, the plan specific guidlines, the medication and then relate it all back to the letter. I determine if it makes sense clinically and how it fits into the members plan and then I make a decision. Each one is different and can take me anywhere from 10 minutes to an hour or more to do. There is no emphasis on speed or production or quotas. The emphasis is on quality and doing a complete full and fair review each and every time and getting it right the first time. I am in freaking heaven and I love it!

Yes, retail is doomed. The current business model is unsustainable. There will be big changes soon and they will not be good for the profession.

Do you see PBM pharmacists getting laid off in the next 10, 20 years? Job security is very important to me.

 

[MountainPharmD]

Do you see PBM pharmacists getting laid off in the next 10, 20 years? Job security is very important to me.

I see retail pharmacists getting laid off in the next 5 years and to be largely replaced by technology, super technicians and mandatory mail order in the next 10 to 20 years.

The main reason I went over to the PBM side was job security. PBMs are here to stay and are only going to get bigger. When Obamas was crafting his heathcare reform plan I remember reading how his team had consulted PBMs like Caremark and Express scripts because they would be responsible for managing the benefit for the government. Thats job security.

 

[UConn101]

I see retail pharmacists getting laid off in the next 5 years and to be largely replaced by technology, super technicians and mandatory mail order in the next 10 to 20 years.

The main reason I went over to the PBM side was job security. PBMs are here to stay and are only going to get bigger. When Obamas was crafting his heathcare reform plan I remember reading how his team had consulted PBMs like Caremark and Express scripts because they would be responsible for managing the benefit for the government. Thats job security.

Very insightful!

Would you recommend your friends/relatives to go to into the PBM side as pharmacists?

How difficult is it to move up within a PBM? I'd imagine easier than retail/hospital...

 

[Its Z]

I see retail pharmacists getting laid off in the next 5 years and to be largely replaced by technology, super technicians and mandatory mail order in the next 10 to 20 years.

The main reason I went over to the PBM side was job security. PBMs are here to stay and are only going to get bigger. When Obamas was crafting his heathcare reform plan I remember reading how his team had consulted PBMs like Caremark and Express scripts because they would be responsible for managing the benefit for the government. Thats job security.

But but what about the baby boomers...and MTM and pharmaceutical care and...

 

[MountainPharmD]

Very insightful!

Would you recommend your friends/relatives to go to into the PBM side as pharmacists?

How difficult is it to move up within a PBM? I'd imagine easier than retail/hospital...

I have tried recruiting everyone I know and even posted job openings on here. Yes, I would highly recommend it. These jobs are few and far between. When the opportunity presents itself you have to jump on it. Here in a few years when retail finally implodes it will be to late. The best time to get off a sinking ship is before everyone realizes it is sinking. Thats where I think retail is right now. A few smart people can see what is getting ready to happen and have jumped ship. The rest will be totally taken by surprise and be stuck without a job.

There are opportunities to move up however there is a push to promote technicians into supervisor positions. A quick check of the State Boards website shows 54 pharmacists and 353 technicians registered. As you can see the techs far out number the pharmacists. I have been told there are plenty of opportunities to advance if that is what you desire.

 

[Its Z]

You will be replaced by a computer program algorithm.

 

[UConn101]

I have tried recruiting everyone I know and even posted job openings on here. Yes, I would highly recommend it. These jobs are few and far between. When the opportunity presents itself you have to jump on it. Here in a few years when retail finally implodes it will be to late. The best time to get off a sinking ship is before everyone realizes it is sinking. Thats where I think retail is right now. A few smart people can see what is getting ready to happen and have jumped ship. The rest will be totally taken by surprise and be stuck without a job.

There are opportunities to move up however there is a push to promote technicians into supervisor positions. A quick check of the State Boards website shows 54 pharmacists and 353 technicians registered. As you can see the techs far out number the pharmacists. I have been told there are plenty of opportunities to advance if that is what you desire.

That's awesome to hear!

So it looks like the PBM side and hospital side is where it's at....and retail is crashing. I do question how long hospital pharmacies can exist as they don't generate profit...I'm sure directors are scheming on how to cut pharmacy costs...

 

[Rxnupe]

I see retail pharmacists getting laid off in the next 5 years and to be largely replaced by technology, super technicians and mandatory mail order in the next 10 to 20 years.

The main reason I went over to the PBM side was job security. PBMs are here to stay and are only going to get bigger. When Obamas was crafting his heathcare reform plan I remember reading how his team had consulted PBMs like Caremark and Express scripts because they would be responsible for managing the benefit for the government. Thats job security.

I guess it's a safe bet to assume where your vote s being cast on 11- 6-2012 Ididn't know Obamacare had consulted with PBM's which is great news for you unless the election swings to the other guy and Obamacare gets repealed or the Supreme court repeals the whole bill than it's back to square 1.

 

[BuckPharmer2010]

Just like MountainPharmD, I've also recently switched from retail (PIC for major chain) to a PBM. My new position is officially titled "Clinical RPh", I will basically field questions from mail-order members. Calls are pre-screened by techs, they handle the majority of basic issues that come up.

So far, it has been a very refreshing change of pace. Lunch break (+ two 15-minute breaks), being off my feet, and normal hours (1 Saturday per month, no Sundays) are some of my favorite changes. Much better work environment, positive management, and significantly lower stress are really amazing benefits as well. The decrease in pay as been well worth the improvement in my quality of living.

Things look great for the future as my department and the mail-order facility in general is growing rapidly. If anyone is lucky enough to get a chance to take a job at a PBM (as long as it's not as a verifying RPh - and even some like that kind of work), I would highly recommend it.

 

[UConn101]

Just like MountainPharmD, I've also recently switched from retail (PIC for major chain) to a PBM. My new position is officially titled "Clinical RPh", I will basically field questions from mail-order members. Calls are pre-screened by techs, they handle the majority of basic issues that come up.

So far, it has been a very refreshing change of pace. Lunch break (+ two 15-minute breaks), being off my feet, and normal hours (1 Saturday per month, no Sundays) are some of my favorite changes. Much better work environment, positive management, and significantly lower stress are really amazing benefits as well. The decrease in pay as been well worth the improvement in my quality of living.

Things look great for the future as my department and the mail-order facility in general is growing rapidly. If anyone is lucky enough to get a chance to take a job at a PBM (as long as it's not as a verifying RPh - and even some like that kind of work), I would highly recommend it.

Thanks for your input!

How did you find the position? Was it through networking?

What kind of qualities/traits/characteristics do they look for in applicants?

 

[Rxnupe]

I see retail pharmacists getting laid off in the next 5 years and to be largely replaced by technology, super technicians and mandatory mail order in the next 10 to 20 years.

The main reason I went over to the PBM side was job security. PBMs are here to stay and are only going to get bigger. When Obamas was crafting his heathcare reform plan I remember reading how his team had consulted PBMs like Caremark and Express scripts because they would be responsible for managing the benefit for the government. Thats job security.

MPD, I respectively disagree- I don't see major chains laying off pharmacist UNLESS you have WAGS/ESI disputes, but when I was in Pre-Pharm over 12 years ago they were talking about technology replacing Pharmacist- here's a prime example PBM- the technology for the average person to call in their prescription on the automated IVR has been around for many years- and that' simple technology yet you still have nearly 60% of people who either drop off their refill bottles at the pharmacy or who actually bypass the automation prompt and speak to a pharmacist or tech and give them the rx numbers they ant fill. Also, I would say less than 1 % of my customers use the website to cal in their rx's. Also, the automated dispensing machines have been around for many years- all the major chains have their own respective version- they don't actually replace a Pharmacist- I did discover when my stores ScriptPro went offline for 2 weeks that corporate gives you an additional 30 tech hours - so automated machines will affect your tech budget but I don't see it replacing a FT pharmacist.
Also, in hindsight if more scripts go to mail order than they will have to meet their demand and are they going to instal more automated machines and replace pharmacist? I have a PT tech who works at Prime Therapeutics and they are seriously behind they still have mandatory Sat and mandatory OT. I am still in contact with a good friend at Caremark and she said they are still busy and behind which again is better than being slow and caught up because that's when they start cutting hours, but again hypothetically if Obamacare gets repealed and more people wil have health insurance there still is going to be a demand and need for retail.
Everyone can't go mail order- with the reduce reimbursements on Medicaid it's going to hurt independents, but the big chains are going to be able to absorb the cost- no way you are going to have medicaid prescriptions on Mail order. Now add into the number of minute clinics that are being built I don't see Retail pharmacist getting laid off in masses because the genera model is you get sick- go to the MD- you get a prescription you take it to the retail pharmacy- that model is going to be around for many years.
Now, it's safe to say that perhaps due to low reimbursements perhaps chains that are 24 hour will loo at whether it's worth it to have an overnight pharmacist- but 5 years massive lay offs from retail???? I am just not seeing that happen?

 

[BuckPharmer2010]

Thanks for your input!

How did you find the position? Was it through networking?

What kind of qualities/traits/characteristics do they look for in applicants?

Networking helped a lot, but the job was also posted on their website. Another RPh was hired at the same time as me and that's how they found out about the gig.

They actually prefer people with retail experience. They like people who can multitask (i.e. talk to customers, look up info, type in notes all at the same time) and prioritize well. It probably helps that when they hire former retail people, they feel like they're in a country club and that keeps morale very high haha.

 

[UConn101]

Networking helped a lot, but the job was also posted on their website. Another RPh was hired at the same time as me and that's how they found out about the gig.

They actually prefer people with retail experience. They like people who can multitask (i.e. talk to customers, look up info, type in notes all at the same time) and prioritize well. It probably helps that when they hire former retail people, they feel like they're in a country club and that keeps morale very high haha.

It does sound like a dream come true!

Are you at a regional health plan or a national PBM? Do you see advancements being a real possibility within a PBM?

 

[Rxnupe]

I have tried recruiting everyone I know and even posted job openings on here. Yes, I would highly recommend it. These jobs are few and far between. When the opportunity presents itself you have to jump on it. Here in a few years when retail finally implodes it will be to late. The best time to get off a sinking ship is before everyone realizes it is sinking. Thats where I think retail is right now. A few smart people can see what is getting ready to happen and have jumped ship. The rest will be totally taken by surprise and be stuck without a job.

There are opportunities to move up however there is a push to promote technicians into supervisor positions. A quick check of the State Boards website shows 54 pharmacists and 353 technicians registered. As you can see the techs far out number the pharmacists. I have been told there are plenty of opportunities to advance if that is what you desire.

MPD again glad you are happy in your new role- I was actually leaning very heavy to apply for the supervisor position over the medicaid PBM's money is no longer and issue even if I were to take a pay cut- look at it this way if you were making 130k a year at Retail and the PBM's were paying you 104k a year- you are still going to be living the same lifestyle- it's not like someone is going to 120k to 50k a year, but I like CRK model and hope they continually to do well obviously I have stock in CVS/Caremark so it's good news for me when the CRK side does well- MPD- I just hope CRK continues the great job they are doing on their side.