Kudos to Trump

[Marvin the Martian]

Trump signed an EO that, in part, making PBM fees more transparent. We have discussed them often here, it is good to take on that powerful middleman.

Fact Sheet: President Donald J. Trump Announces Actions to Lower Prescription Drug Prices

LOWERING PRESCRIPTION DRUG PRICES: Today, President Donald J. Trump signed an Executive Order to expand on the historic efforts of his first term to lower

www.whitehouse.gov

Mark Cuban likes it and has more ideas

Mark Cuban optimistic new Trump order could save "hundreds of billions"

Cuban, a prominent Kamala Harris supporter in 2024, is praising the president's executive order to lower prescription drug costs.

www.newsweek.com

 

[mcmurtry66]

Trump signed an EO that, in part, making PBM fees more transparent. We have discussed them often here, it is good to take on that powerful middleman.

Fact Sheet: President Donald J. Trump Announces Actions to Lower Prescription Drug Prices

LOWERING PRESCRIPTION DRUG PRICES: Today, President Donald J. Trump signed an Executive Order to expand on the historic efforts of his first term to lower

www.whitehouse.gov

Mark Cuban likes it and has more ideas

Mark Cuban optimistic new Trump order could save "hundreds of billions"

Cuban, a prominent Kamala Harris supporter in 2024, is praising the president's executive order to lower prescription drug costs.

www.newsweek.com

Yep good stuff. Know quite a few people working at a big PBM making bank. For what. Cuban’s pharmacy is great. Trying to manufacture more. Get a bigger formulary

I’ll never forget years ago when my ex wife told me she got generic Topamax. It was approved. Went from like a grand a month to 38 cents

 

[Marvin the Martian]

Yep good stuff. Know quite a few people working at a big PBM making bank. For what. Cuban’s pharmacy is great. Trying to manufacture more. Get a bigger formulary

I’ll never forget years ago when my ex wife told me she got generic Topamax. It was approved. Went from like a grand a month to 38 cents

It is possible that independent PBMs would work. But the idea that CVS owns the PBM that negotiates with CVS on costs manages to keep prices down? That is ludicrous on the face of it. We might as well let Putin choose the Politburo as the neutral arbiter in Ukraine.

 

[mcmurtry66]

It is possible that independent PBMs would work. But the idea that CVS owns the PBM that negotiates with CVS on costs manages to keep prices down? That is ludicrous on the face of it. We might as well let Putin choose the Politburo as the neutral arbiter in Ukraine.

Yep. Express scripts is here. I guess before mergers etc was a fortune 25 co. 8,000 vps all making a ton of money

 

[crazed_hoosier2]

It is possible that independent PBMs would work. But the idea that CVS owns the PBM that negotiates with CVS on costs manages to keep prices down? That is ludicrous on the face of it. We might as well let Putin choose the Politburo as the neutral arbiter in Ukraine.

I always thought the merger of CVS and Caremark should've been blocked. And I have to imagine that CVS' market share has only risen since then. I'm guessing -- haven't seen data. But given the influence that PBMs have, that strikes me as anti-competitive.

FWIW, the health insurance fund I'm a trustee on dumped CVS Caremark for Medimpact* a few years ago. It absolutely helped with pharmaceutical costs. But we're still struggling mightily with them. Just slashed our coverage for GLP-1s -- which, honestly, would probably be a great thing to cover. But almost overnight, they became almost 5% of our overall pharmaceutical spend (and growing).

Also....the single best thing the federal government could do to help our pharmaceutical costs is to use our trade leverage to get other countries to foot more of the bill. Pharmaceuticals suffer from a free rider problem -- and the effect is that American consumers subsidize the hell out of consumers almost everywhere else.

We shouldn't just follow their lead an institute price controls. We should however get them to lift theirs.


* Re: your comment. Medimpact is an independent PBM. It's helped. It's not going to fix the underlying problem. But it has definitely helped.

 

[Baller23Boogie]

Trump signed an EO that, in part, making PBM fees more transparent. We have discussed them often here, it is good to take on that powerful middleman.

Fact Sheet: President Donald J. Trump Announces Actions to Lower Prescription Drug Prices

LOWERING PRESCRIPTION DRUG PRICES: Today, President Donald J. Trump signed an Executive Order to expand on the historic efforts of his first term to lower

www.whitehouse.gov

Mark Cuban likes it and has more ideas

Mark Cuban optimistic new Trump order could save "hundreds of billions"

Cuban, a prominent Kamala Harris supporter in 2024, is praising the president's executive order to lower prescription drug costs.

www.newsweek.com

Fantastic. This is something we should all be able to get behind.

With that being said, can he whip up something for daylight savings? Just keep it where it is now. Stop the nonsense.

 

[crazed_hoosier2]

Fantastic. This is something we should all be able to get behind.

With that being said, can he whip up something for daylight savings? Just keep it where it is now. Stop the nonsense.

Daylight Savings Time is the other third rail of politics.

 

[Spartans9312]

It is possible that independent PBMs would work. But the idea that CVS owns the PBM that negotiates with CVS on costs manages to keep prices down? That is ludicrous on the face of it. We might as well let Putin choose the Politburo as the neutral arbiter in Ukraine.

Here’s a typical pharmacy reimbursement contract….AWP-17%+$1

The difference between AWP and ACQ is 19% on brand name products.

Take a product like Nexium before it went generic. A bottle of 90 cost the pharmacy roughly $350.

So on an order of that size the pharmacy made about $8. Not much roi.

PBMs need eliminated.

 

[BadWakeboarder]

I always thought the merger of CVS and Caremark should've been blocked. And I have to imagine that CVS' market share has only risen since then. I'm guessing -- haven't seen data. But given the influence that PBMs have, that strikes me as anti-competitive.

FWIW, the health insurance fund I'm a trustee on dumped CVS Caremark for Medimpact* a few years ago. It absolutely helped with pharmaceutical costs. But we're still struggling mightily with them. Just slashed our coverage for GLP-1s -- which, honestly, would probably be a great thing to cover. But almost overnight, they became almost 5% of our overall pharmaceutical spend (and growing).

Also....the single best thing the federal government could do to help our pharmaceutical costs is to use our trade leverage to get other countries to foot more of the bill. Pharmaceuticals suffer from a free rider problem -- and the effect is that American consumers subsidize the hell out of consumers almost everywhere else.

We shouldn't just follow their lead an institute price controls. We should however get them to lift theirs.


* Re: your comment. Medimpact is an independent PBM. It's helped. It's not going to fix the underlying problem. But it has definitely helped.

All of the big insurance companies have since bought a PBM. Once one happened, couldn’t block the others.

 

[crazed_hoosier2]

All of the big insurance companies have since bought a PBM. Once one happened, couldn’t block the others.

Yeah, CVS Health is highly integrated with the CVS retail/mail pharmacy, the Caremark PBM, and Aetna health insurance.

It's a problem -- although I honestly don't think it's the biggest cost-driver facing healthcare or even the pharmaceutical sector. As for pharma, that's one thing that Trump might actually be able to help with his opening of Pandora's Box on global trade.

I've never been terribly concerned with trade deficits. But the free-rider thing so many countries have going on with pharmaceuticals needs to be dealt with. In that case, we actually are getting fleeced.

 

[larsIU]

although I honestly don't think it's the biggest cost-driver facing healthcare or even the pharmaceutical sector.

Ohhhhh, a guessing game.

I'll say....OBESITY.

 

[crazed_hoosier2]

Ohhhhh, a guessing game.

I'll say....OBESITY.

It would be on the list, too. Numerous things are -- smoking and other forms of recreational substances.

But, for me, #1 on the list is our good friend the unicorn.

 

[crazed_hoosier2]

Yeah, CVS Health is highly integrated with the CVS retail/mail pharmacy, the Caremark PBM, and Aetna health insurance.

It's a problem -- although I honestly don't think it's the biggest cost-driver facing healthcare or even the pharmaceutical sector. As for pharma, that's one thing that Trump might actually be able to help with his opening of Pandora's Box on global trade.

I've never been terribly concerned with trade deficits. But the free-rider thing so many countries have going on with pharmaceuticals needs to be dealt with. In that case, we actually are getting fleeced.

Oh man, as if on cue.

Trump looking at cutting US drug prices to international levels, sources say

This is…not the way we want to go about doing this. In keeping with his populist themes, yes. But it’s (once again) terrible economics.

“How could you possibly want people to pay higher drug prices, Crazed? Aren’t lower prices good? Big Pharma makes plenty of money!”

 

[JamieDimonsBalls]

It would be on the list, too. Numerous things are -- smoking and other forms of recreational substances.

But, for me, #1 on the list is our good friend the unicorn.

I'm not following. How is anything near obesity?

 

[Marvin the Martian]

Daylight Savings Time is the other third rail of politics.

DST is what proves the kabuki theater that is congress. In '22. Rubio wanted for unanimous consent to make DST permanent. Wicker was supposed to vote against unanimous consent, and everyone would be happy. But Wicker's plane was delayed, so Rubio waited to make the request the next day. In the meantime, Wicker decided not to actively oppose it, but no one told Tom Cotton who would have killed it. So Cotton wasn't there to oppose it. The result was that it passed unanimously as everyone sat around puzzled over how they managed to pass something.

The House bailed them out by never taking it up.

 

[Spartans9312]

Oh man, as if on cue.

Trump looking at cutting US drug prices to international levels, sources say

This is…not the way we want to go about doing this. In keeping with his populist themes, yes. But it’s (once again) terrible economics.

“How could you possibly want people to pay higher drug prices, Crazed? Aren’t lower prices good? Big Pharma makes plenty of money!”

There is no way they will do this correctly

 

[crazed_hoosier2]

There is no way they will do this correctly

I fear you're right.

However, it's at least somewhat encouraging that this is a "mid-level" Trump priority. I'd rather they did nothing than do something that screams out for unintended consequences.

I agree that drug prices are a huge problem. I see it first hand at our trustees meetings. And I wouldn't have the first problem with using public policy to alleviate this.

But it has to be done in a way that pushes more of the burden on foreign markets. Because just slashing dollars would almost certainly have negative affects on supply -- including the all-important development.

 

[Spartans9312]

I fear you're right.

However, it's at least somewhat encouraging that this is a "mid-level" Trump priority. I'd rather they did nothing than do something that screams out for unintended consequences.

I agree that drug prices are a huge problem. I see it first hand at our trustees meetings. And I wouldn't have the first problem with using public policy to alleviate this.

But it has to be done in a way that pushes more of the burden on foreign markets. Because just slashing dollars would almost certainly have negative affects on supply -- including the all-important development.

Are you seeing acquisition cost of pharmaceuticals for a hospital?

If so…can you also see reimbursement contract for just pharmaceuticals?

 

[crazed_hoosier2]

Are you seeing acquisition cost of pharmaceuticals for a hospital?

If so…can you also see reimbursement contract for just pharmaceuticals?

Oh no, we don't get that kind of information. I wish we did. In fact, we're constantly fighting with our service providers for more detailed, granular, and transparent cost information. To say they're reluctant to give it would be an understatement. They give us what is required by law and nothing more.

Two meetings ago, reps from BCBS Illinois (they're our PPO Network Admin service provider) came to their first meeting in the 10ish years I've been a trustee. And this was the topic. They took some heat from numerous trustees, including yours truly, and basically just sat there motionless.

 

[Spartans9312]

Oh no, we don't get that kind of information. I wish we did. In fact, we're constantly fighting with our service providers for more detailed, granular, and transparent cost information. To say they're reluctant to give it would be an understatement. They give us what is required by law and nothing more.

Two meetings ago, reps from BCBS Illinois (they're our PPO Network Admin service provider) came to their first meeting in the 10ish years I've been a trustee. And this was the topic. They took some heat from numerous trustees, including yours truly, and basically just sat there motionless.

If you are on a hospital board then that information should be available to you. If not directly from BCBS then most definitely from administration responsible for contracting.

 

[crazed_hoosier2]

If you are on a hospital board then that information should be available to you. If not directly from BCBS then most definitely from administration responsible for contracting.

I am on a hospital board - but there are several at the institution. The particular board I'm on does not have access to anything but public financial data. They would look at me funny if I asked them for this and I'm guessing my term wouldn't get renewed.

This multiemployer health insurance board can't get it. Trust me, we've asked -- and when I say "we", I'm talking about our benefits consultant and legal counsel, acting on our behalf. They will not give it to us, and don't care if we threaten them with an RFP.