PBMs, Walgreens and CVS

[PharmD RPh]

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So this whole PBM/pharmacy battle is getting interesting and was curious what everyone thought about it. Express Scripts is trying to buy Medco. Walgreens drops Express Scripts. Caremark gets United Healthcare and Federal Employee contract away from Medco. Walgreens sells its PBM. What do you guys think about the following?

1. What do you think are the odds of a Walgreens and Express Scripts contract working out?
2. Why would Walgreens sell it's PBM when it appears that you could do what CVS is doing and go after every contract you can so you can funnel your PBM customers into your CVS store and away from competitors like Walgreens and Rite Aid?
3. Thoughts about Caremark being dismantled from CVS due to anti-trust?

 

[Aznfarmerboi]

So this whole PBM/pharmacy battle is getting interesting and was curious what everyone thought about it. Express Scripts is trying to buy Medco. Walgreens drops Express Scripts. Caremark gets United Healthcare and Federal Employee contract away from Medco. Walgreens sells its PBM. What do you guys think about the following?

1. What do you think are the odds of a Walgreens and Express Scripts contract working out?
2. Why would Walgreens sell it's PBM when it appears that you could do what CVS is doing and go after every contract you can so you can funnel your PBM customers into your CVS store and away from competitors like Walgreens and Rite Aid?
3. Thoughts about Caremark being dismantled from CVS due to anti-trust?

1. I think Walgreens and Express script will work out a contract soon. Walgreen loves to play brinksmanship but ultimately, it will hurt their bottom line.

2. Walgreen sold its PBM because it was not working out for them. They wanted to focus on their core business which is retail. For CVS Caremark, they are still trying to find synergy between both companies. CVS is very commited into making it work though.

3. I do not think CVS Caremark will be dismantled. Ultimately, the laws are there to prevent a company from having an unfair advantage and hurting the consumer. As of right now, that is not the case. There are bigger mergers in other industries that the government have approved.

Also, people can quote how many investigations there are on CVS Caremark in terms of unfair practices. I have not seen any of those investigations resulting in action against the company.

 

[StallionRx]

1. I think Walgreens and Express script will work out a contract soon. Walgreen loves to play brinksmanship but ultimately, it will hurt their bottom line.

2. Walgreen sold its PBM because it was not working out for them. They wanted to focus on their core business which is retail. For CVS Caremark, they are still trying to find synergy between both companies. CVS is very commited into making it work though.

3. I do not think CVS Caremark will be dismantled. Ultimately, the laws are there to prevent a company from having an unfair advantage and hurting the consumer. As of right now, that is not the case. There are bigger mergers in other industries that the government have approved.

Also, people can quote how many investigations there are on CVS Caremark in terms of unfair practices. I have not seen any of those investigations resulting in action against the company.

Agree with all except number 1.

According to the conference call last Monday, Wags and Express are still "miles apart". The CEO seems very solid on his stance regarding the issue. Id like to see them patch things up, but I think Wags may be looking for contracts else where. They better do something soon because their shareholders are not happy.

 

[Dr Wario]

Agree with all except number 1.

According to the conference call last Monday, Wags and Express are still "miles apart". The CEO seems very solid on his stance regarding the issue. Id like to see them patch things up, but I think Wags may be looking for contracts else where. They better do something soon because their shareholders are not happy.

What is really sad is that this was a great opportunity to take the massive profits from the pbms and send them back to the actual value-added services. CVS could have ensured long-term increase in profits by siding with Walgreens and instead opted for short term increase in market share. Shame on you CVS, your shortsighted greed will cost you billions in profit down the road because now the entire world will know that pharmacy will not stand against unfair reimbursement rates. See how your contracts will dwindle in the future because they don't have to be afraid of you anymore.

By the way, Thank you for calling CVS/Pharmacy, home of the flu shot, may I take your order?

 

[lorain]

What is really sad is that this was a great opportunity to take the massive profits from the pbms and send them back to the actual value-added services. CVS could have ensured long-term increase in profits by siding with Walgreens and instead opted for short term increase in market share. Shame on you CVS, your shortsighted greed will cost you billions in profit down the road because now the entire world will know that pharmacy will not stand against unfair reimbursement rates. See how your contracts will dwindle in the future because they don't have to be afraid of you anymore.

By the way, Thank you for calling CVS/Pharmacy, home of the flu shot, may I take your order?

"uh yes hi, im coming thru the drive thru in about 10 minutes, can you also give me tylenol, milk, and bread along with my rx bag? if you say no, i want the # of your supervisor"

 

[lorain]

Agree with all except number 1.

According to the conference call last Monday, Wags and Express are still "miles apart". The CEO seems very solid on his stance regarding the issue. Id like to see them patch things up, but I think Wags may be looking for contracts else where. They better do something soon because their shareholders are not happy.

lets see how things work out

every1 likes to talk a big game

i still think it gets worked out

 

[Unchained]

Dr Wario CVS cannot take the same position as WAG because they own a PBM which would directly benefit.

 

[PharmDstudent]

Agree with all except number 1.

According to the conference call last Monday, Wags and Express are still "miles apart". The CEO seems very solid on his stance regarding the issue. Id like to see them patch things up, but I think Wags may be looking for contracts else where. They better do something soon because their shareholders are not happy.

This whole debacle is starting to scare me. My district is full of Express Scripts patients; it's not looking good for pharmacists...

 

[joetrisman]

This whole debacle is starting to scare me. My district is full of Express Scripts patients; it's not looking good for pharmacists...

A lot can happen in two months. I tend not to worry as nationally walgreens fills 1 in 5 scripts if I recall correctly

 

[oh no dont stop]

1. I think Walgreens is trying to positioning itself for the bigger picture. (A reformed neopolitical healthcare model in the U.S) They are choosing to go with a service based model rather than a commodity based model which pharmacy has historically been. This shift has only begun to occur in the last decade.

2. Currently, drug rebates are not disclosed between manufacturer and payer. Walgreens is pushing (as the general public should) for disclosure of such rebates. These rebates play a crucial role in determining to cost for the end user (i.e. employers and patients). It is a political move to gain bargaining power, but has industry-wide implications.

3. I think real world economics takes over and Walgreens ultimately settles. This is just my gut instinct. Losing 5.2 billion in revenue ultimately seems pretty risky I think, simply because I continue to think the single most driver for pharmacy business is convenience.

 

[Farmercyst]

It's getting pretty ugly and stupid. Mandatory insurance "consults" on all Express Scripts telling them they need to contact their HR to change PBMs from them. Express scripts having prompts telling people how to transfer their WAGs Rxs to a different pharmacy. PartD members being told that WAGs is having consultation sessions after 10/15 on how to pick a plan right after informing them that they use an express scripts plan and WAGs won't be able to provide their Rxs next year under their current plan. The almighty dollar and corporate greed at work on both sides.

 

[PharmDstudent]

It's getting pretty ugly and stupid. Mandatory insurance "consults" on all Express Scripts telling them they need to contact their HR to change PBMs from them. Express scripts having prompts telling people how to transfer their WAGs Rxs to a different pharmacy. PartD members being told that WAGs is having consultation sessions after 10/15 on how to pick a plan right after informing them that they use an express scripts plan and WAGs won't be able to provide their Rxs next year under their current plan. The almighty dollar and corporate greed at work on both sides.

... and unprofessional. What's next? I think it's absolutely ridiculous to get patients involved in all of this.


Oh, and I like your location: "The bottom of a pile of debt", by the way. Isn't it crazy to have the pharmacy school blinders off and realize what that debt really means?

 

[Farmercyst]

... and unprofessional. What's next? I think it's absolutely ridiculous to get patients involved in all of this.


Oh, and I like your location: "The bottom of a pile of debt", by the way. Isn't it crazy to have the pharmacy school blinders off and realize what that debt really means?

I agree there has to be a more professional way to let patients know what's happening, the cause and affect, without tossing blame and trying to convince them to choose one side or the other. The current phrasing for the Part D members is particularly unethical in my opinion.

I'm sorry, you're with express scripts and we won't be able to fill your prescriptions starting next year. Did you know we're having Part D counseling sessions starting 10/15, if you'd like an appointment I can schedule one for you.

Apparently express scripts customers are the only ones that need help selecting a plan. We only have time to make appointments for them (except there's not really any additional time)

As for my location, I've had that location since my first GradPlus loan. And will probably keep it until the last one is paid off.