Most profitable items in a pharmacy?

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Lexington2012

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  1. Pharmacy Student
What sort of items do you know for a fact are highly profitable in your pharmacy? I am guessing flu shots based on how the chains are pushing them. Anything else come to mind?
 
Generic antipsychotics when Medi-Cal stopped mandating brand only for coverage earlier in the year (quetiapine and olanzapine especially). Like $20-40 net a fill (based on nominal acquisition cost) but I haven't checked recently.

Generic aripiprazole when you submit a treatment authorization request to Medi-Cal with the generic NDC that somehow bypasses the reviewing pharmacist (only brand Abilify is a contract drug at the moment). ~$300 net reimbursement (again versus "nominal" cost) that will probably get clawed back later because the claim was for generic aripiprazole.

Walmart
 

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Aripiprazole, 5 & 10mg rosuvastatin, and 3% diclofenac gel.
We've seen crazy reimbursements with some of these.

Aside from that, generic lovaza has been >$100 net profit for some plans.

Compounds

Somebody's getting their pharmacy doors kicked in by Medicare and tricare agents soon. Lol.
 
Twinkies and other stoner food including tobacco at the front end by a fair amount in a traditional pharmacy (last direct knowledge from area accounting is around 2010 or so, but I believe it is still true today). There were individual items in the pharmacy that are theoretically more profitable (e.g. compounding), but at the volume sold with the higher margins, definitely Twinkies.
 
As in total profit dollars generated on all sales of the item(includes volume), profit dollars per unit solid (includes high priced items), profit dollars as a percent of sales price per unit (includes cheap stuff with high mark ups)?
 
I forgot to mention that anything on the "$4/$10" list is still profitable per unit but when your pharmacy sales per Rx is $34-35/Rx the pharmacy doesn't come close to breaking even. This contrasts with ~$50-55 at my old CVS.
 
The profit margin on greeting cards is pretty high.
 
Depends. It changes from week to week and month to month. How would like to be the buy that had loads of Doxycycline at $30.00 for 500 and now it costs almost if not moire than $1,000.00 for 500. It would be great if we were plugged into the wholesale chemical market and you knew which chemicals were going to have a shortage next and thereby drive up the price of some innocuous drug into the stratosphere.
 
This always cracks me up. I once said the same thing (compounds are a cash business) and several posters called me out and insisted that compounds can be billed to insurance and that I must not know what I am doing or know which override codes to use. But every pharmacy I ever worked at or rotated through were mostly cash only for compounds. Good thing, apparently.
 
Those $10 greeting cards are probably 1000% profit, whether it's for the card company or pharmacy I'm not sure but people actually buy them.
 
This always cracks me up. I once said the same thing (compounds are a cash business) and several posters called me out and insisted that compounds can be billed to insurance and that I must not know what I am doing or know which override codes to use. But every pharmacy I ever worked at or rotated through were mostly cash only for compounds. Good thing, apparently.
I think they were just being secretive because they didn't want to expose the racket they were in. Up until a few years ago you could bill certain insurance plans for compounds, in particular Tricare, and they would reimburse you up to $20,000 for creams containing certain ingredients. So they got greedy and got sales reps to go out and market these creams to military people, and paid kickbacks to the doctors, sales reps and patients. This is of course illegal on so many levels such as the Fraud, Waste and Abuse laws, Anti-Kickback Statute, pharmacy compounding laws, etc. Now most insurances do not cover compounds due to this abuse, but they are also going back and issuing charge backs, or the Feds are even handing out indictments to the really fraudulent pharmacies.
 
For as much money as they lost I figured people were just flat out billing for scripts that didn't exist.
 
You're missing the point. Compounds are cash payment. No insurance is being billed....what does tricare have to do with a cash transaction? And who hasn't heard about this....?
... Do you even work in an independent?

Did you click the links pezdispenser posted? Did you see the blue link in the post you quoted?

Am I responding to a tongue in cheek post? LOL. I honestly can't even tell.

It kinda sounds like the answer is no.
 
This always cracks me up. I once said the same thing (compounds are a cash business) and several posters called me out and insisted that compounds can be billed to insurance and that I must not know what I am doing or know which override codes to use. But every pharmacy I ever worked at or rotated through were mostly cash only for compounds. Good thing, apparently.

Yeah, I won't go near any state funded claims for compounds.

Maybe his background is blue and he can't see all of the links?
 
... Do you even work in an independent?

Did you click the links pezdispenser posted? Did you see the blue link in the post you quoted?

Am I responding to a tongue in cheek post? LOL. I honestly can't even tell.

It kinda sounds like the answer is no.


Uhhhhh.. yeah I do work at an indy. Want my NPI? I did click the links...and each one is regarding fraud due to billing compounds to tricare /(INSURANCE), kickback scheme, or money laundering, NOT from compounding alone. If a prescription is legitimately written then I don't see why anyone would have anything to worry about. There are rotten apples everywhere. There are also thousands of indy pharmacies out there that do everything on the level. I reiterated my point...compounds = cash. There is nothing illegal going on if someone has the desire to get their cats methimazole in cream form, or for a menopausal woman to want BHRT, or for someone in pain to pay CASH for a pain cream that helps them out....


United States Settles False Claims Act Allegations Against Compound Pharmacy Owners For $7.75 Million
Jacksonville, FL – United States Attorney A. Lee Bentley, III announces today that Andy Miller, Tracy Miller, and the Healthmark Investment Trust have agreed to pay to the government $7.75 million to resolve allegations that they violated the False Claims Act.

The United States contends that QMedRx, a compound pharmacy in Maitland, Florida, knowingly billed federal healthcare programs for services that were not reimbursable. Specifically, the government contends that from January 1, 2013, until January 22, 2014, QMedRx submitted to federal healthcare programs, compounded prescriptions that were tainted within the meaning of the Anti-Kickback Statute. Because Healthmark Investment Trust was a partial owner of QMedRx, the government sought penalties and fines from the owners who participated in the fraud. The government is still pursuing penalties and fines from other owners and participants within QMedRx.

Eight Individuals Charged In Multimillion-Dollar Compounding Pharmacy Fraud Scheme
Tampa, FL – Eight Florida residents were charged in an indictment that was unsealed today for their alleged participation in a multimillion-dollar fraud scheme involving prescription compounding pharmacies located in the Tampa Bay area and in Miami.

U.S. Attorney A. Lee Bentley III of the Middle District of Florida, Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Special Agent in Charge Paul Wysopal of the FBI’s Tampa Field Office, and Special Agent in Charge George Piro of the FBI’s Miami Field Office made the announcement.

Nicholas A. Borgesano Jr., 43, of New Port Richey; Bradley Sirkin, 54, of Boca Raton; Scott D. Piccininni, 47, of Fort Lauderdale; Edwin Patrick Young, 48, of New Port Richey; Wayne M. Kreisberg, 39, of Parkland; Matthew N. Sterner, 47, of New Port Richey; Peter D. Williams, 55, of New Port Richey, and Joseph Degregorio, 71, of New Port Richey, were each charged in a 12-count indictment returned on Aug. 3, 2016, with conspiracy to commit health care fraud and wire fraud. Borgesano, Sirkin, Piccininni, Kreisberg and Sterner were each also charged with three money laundering counts. Several defendants were arrested today and will have their initial appearances in federal courts in the Middle and Southern Districts of Florida.

According to the indictment, from approximately October 2012 through December 2015, the co-conspirators allegedly used A to Z Pharmacy Inc., located in New Port Richey, and several Miami-area pharmacies to cause the submission of false and fraudulent reimbursement claims for prescription compounded medications to private insurance companies, Medicare and Tricare. These reimbursement claims were allegedly based on prescriptions generated as a result of illegal kickbacks and bribes, prescriptions that were not based on legitimate provider/patient relationships and misuse of patient information. Additionally, the reimbursement claims allegedly represented that medications contained certain pharmaceutical ingredients when they did not. In addition to A to Z Pharmacy, the defendants used Medplus/New Life Pharmacy, Metropolitan Pharmacy, Havana Pharmacy, Jaimy Pharmacy and Prestige Pharmacy to submit the reimbursement claims, according to the indictment.

Three Military Members Indicted For Paying Kickbacks To Tricare Beneficiaries To Obtain Prescriptions For Compounded Medications
Tampa, FL – United States Attorney A. Lee Bentley, III announces the return of an indictment charging Cordera Hill (27, Tampa), Anthonio Miller (25, Tampa), and Rashad Barr (24, St. Petersburg) with one count of conspiracy and nine counts of offering to pay and paying kickbacks in connection with a federal health care benefit program. If convicted, each faces a maximum penalty of five years in federal prison on each count. The indictment also notifies the individuals that the United States intends to forfeit the proceeds traceable to the offenses.

Pinellas County Doctor Arrested And Charged With Multiple Offenses Related To Writing Prescriptions For Compounded Medications
Tampa, FL – United States Attorney A. Lee Bentley, III announces the unsealing of an indictment charging Dr. Anthony Baldizzi (52, Tierra Verde) with one count of conspiracy to defraud the United States, twenty-one counts of health care fraud, one count of money laundering, one count of making a false statement, and one count of receiving illegal kickbacks. The health care fraud and money laundering counts each carry a maximum penalty of 10 years in federal prison. The remaining counts each carry a maximum penalty of five years. The indictment also notifies Baldizzi that the United States is seeking a money judgment in the amount of at least $5.3 million as proceeds of the conspiracy and health care fraud offenses and forfeiture of a 2015 BMW M3, which is alleged as property traceable to proceeds of the charged conduct.
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Twenty-five people were arrested in June, accused of committing fraud against TRICARE, the health plan for 9.4 million military service members, retirees, their families and survivors. The arrests were associated with $47 million in fraudulent compound drug claims paid by TRICARE in recent years.



soooooo did you read the links he posted?
 
I honestly can't tell if you're being serious.


Here's your last post in a nutshell.

"Uuummmm... Omg like, these articles don't even like mention apples


STATE INVESTIGATING CLAIMS OF APPLES

Apples apples apples apples apples apples apples apples apples pears and oranges apples apples apples apples apples apples apples apples apples apples



Sssoooo like omg did yyooouuu read the articles?"

EDIT:
Ohhhhh, I think I get it.

You somehow misunderstood the posts to mean that cash compounds are somehow going to get people in trouble.
A. You should go back and re-read the posts.
B. How did you even get that from my post? Bizarre.

I also might be missing your point because of your incorrect use of ellipses and poor sentence structure.
It's hard to understand what you're trying to convey. I apologize if I have misunderstood whatever it is you're trying to communicate. It's like a text version of vocal fry.
If you're trying to assert that compounds *cannot* be successfully billed to third parties by quoting articles about people who got in trouble after billing compounds to third parties then I don't know what to say.

Also, some commercial third parties do pay for compounds.

Yes, regular cash compounds can be kinda profitable, I guess.
 
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