Understanding Competition in U.S. Prescription Drug Markets: Entry and Supply Chain Dynamics #00380

Submission Number:
Shan Patel
Initiative Name:
Understanding Competition in U.S. Prescription Drug Markets: Entry and Supply Chain Dynamics
Mergers between PBM and plans is a big threat to Pharmacy indrustry. We had seen this already with CVS previously acquiring Caremark. There are 26 to 27k Independent Pharmacies in Country who are truly winning business over CVS and Walgreens just because of the Care they are providing to their customers and services they offer over big Chain Pharmacues . CVS/ Caremark and some other PBM who owe mail orlder Pharmacies are directing their customers to Thier Pharmacies because they have access to Data on patients and their Medications. Since they Own PBM piece they started Either taking this small independent Pharmacies out of network / take a year before they enroll them into network ( so they feel hardship and can't stay in business ) or creat a Bond that cost them Arms and leg ( Express Scripts started or Charge them a High DIR fees ( i don't even know how they come up with how much to charge ) or Pay them under water Claims and Bind them in contract where they still have to service the patient at loss ( show me one business in USA where owner have to do business legally even they are doing business at loss ( before taking out expenses. Currently PBM are reimbursing Independent pharmacies below thier drug cost ( not even counting other expenses and Pharmacist salary ). And when you submit a request or appeal for proper reimbursement they always deny. How PBM mergers will bring quality in patient care if they are not even properly Reimbursing Providers ?? I don't know how PBM can make money from Manufactures , Plans , Pharmacies and Data and system is allowing them and on top of that now less compition will help ?? PBM mergers will creat monopoly in market and less compition. More narrow network limiting access for patient to go to other pharmacies. Mail order business and waste of medications. Perception gets created in patient mind that they have to use CvS because that's where their insurance is from Less competition between PBMs and insurance create Monopoly for CVS /Caremark