Posted on 01/16/2025 10:03:57 AM PST by Angelino97
OptumRx, the group’s pharmacy benefit manager, along with its two main peers, Express Scripts and CVS Caremark Rx, have pocketed an extra $7.3 billion over cost thanks to price gouging, according to the findings of a report by the Federal Trade Commission. CVS Caremark Rx blasted the findings for cherry picking certain drugs in an effort to push what it called an ‘anti-PBM’ narrative.
The report, which levels the same allegations at CVS and Cigna, is the latest indictment of America’s broken healthcare system and comes on the heels of last month’s shocking murder of UnitedHealthcare CEO Brian Thompson.
The U.S. is notorious for incurring the highest costs per capita of any wealthy nation, yet failing to achieve an even remotely equivalent improvement in patient outcomes versus Europe’s social market-based economies.
Critics argue that is due largely to the highly opaque manner in which needless markups are hidden to conceal inefficiencies that serve various vested interests. These include the big three drug middlemen known as pharmacy benefit managers (PBMs).
According to the FTC report, UnitedHealth’s OptumRx, along with Cigna’s Express Scripts and CVS Caremark Rx, were able to collectively pocket $7.3 billion in added revenue above cost during the five year period of the study through 2022.
“The Big 3 PBMs marked up numerous specialty generic drugs dispensed at their affiliated pharmacies by thousands of percent, and many others by hundreds of percent.”
A thousand percent increase in the price of a drug that costs $10 wholesale would result in a retail price of $110.
This markup rate applied to 22% of the specialty therapies examined, including Imatinib , a generic used to treat leukemia, or non-oncological Tadalafil for pulmonary hypertension. Others such as Lamivudine needed by HIV-positive patients were nearly quadruple the price of their acquisition cost.
(Excerpt) Read more at fortune.com ...
Insurance companies don’t charge patients, doctors/hospital do.
That’s right.
He did not deserve to be murdered for it.
lol...Insurance companies run the entire medical industry.
Every week both my husband and I get a phone call from a pharmacy manager (Express Scripts or CVS) trying to scam us into having them manage our prescriptions.
At first you think it is your pharmacy calling to remind you a prescription is due for refill. But, if you select “1” for yes, then suddenly you no longer have control over your prescriptions. They pretend to be cost-savers but in the long run I think you end up paying more.
If the shooter had a relative who died from cancer after stuff like this, maybe insanity might be a plea.
If the shooter had a relative who died from cancer after stuff like this, maybe insanity might be a plea.
The FTC’s second interim staff report analyzed all specialty generic drugs dispensed from 2017 to 2022 for members of commercial health plans and Medicare Part D prescription drug plans managed by the Big 3 PBMs for which the FTC has relevant data.
Its Government, declaring that United Health and the "Big 3 PBMs" overcharged GOVERNMENT for generic cancer drugs
This is the bloated, expensive, crony-capitalist, self-licking-ice-cream-cone system generations of leftists and progressive since FDR have created.
Drug companies.
Big pharma, big insurance...You bet.
Not true. If anything, the AMA plays a more important part by regulating the number of doctors in the marketplace. The AMA controls the supply of doctors, both through med school controls and through state licensing exams. If you can fog a mirror, you can practice medicine in Alaska, North and South Dakota, and many other less desirable locations. However, those states where doctors tend to retire (FL, CA, AZ) have some of the toughest licensing exams anywhere. The reason is because they don't want retired doctors to practice medicine, thus lowering doctors' incomes.
Is reading comprehension your issue, or just ignorance?
“for members of commercial health plans and Medicare Part D prescription drug plans”
The government doesn’t pay the premiums for either commercial health plans or Part D.
Now, if they were talking about VA plans or Medicaid, you’d have an argument. But what you posted didn’t deal with “entitlement” plans.
Bingo.
Why U such an angry snot?
What is Medicare Part D? from Fed.gov website: Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans approved by the government or that contract with the federal government. Beneficiaries can choose to enroll in either a stand-alone prescription drug plan (PDP) to supplement traditional Medicare or a Medicare Advantage plan, mainly HMOs and PPOs, that provides all Medicare-covered benefits, including prescription drugs (MA-PD). Part B and Part D benefits are paid from the Supplementary Medical Insurance Trust Fund (about 25 percent funded by premiums paid by enrollees and about 75 percent funded from general revenues).
Government chooses which private providers participate, government chooses which drugs are covered, government subsidizes specific drugs.
If Fed.gov is involved, it chooses and it PAYS at some level.
“...the latest indictment of America’s broken healthcare system”
As a physician, I can tell you that fewer than 20% of American doctors belong to the AMA. The AMA makes much more money licensing its ICD-10 medical coding system than dues from members. In the past 25 years, Texas has opened up five new medical schools without AMA input (it is a political decision). The AMA has no control over foreign doctors entering the country, which there have been a lot over the last two decades (mainly from India). The licensing exam is the same for all of us graduates but might be different for foreign doctors (this I don’t know).
As a physician, I can tell you that fewer than 20% of American doctors belong to the AMA. The AMA makes much more money licensing its ICD-10 medical coding system than dues from members. In the past 25 years, Texas has opened up five new medical schools without AMA input (it is a political decision). The AMA has no control over foreign doctors entering the country, which there have been a lot over the last two decades (mainly from India). The licensing exam is the same for all of us graduates but might be different for foreign doctors (this I don’t know).
That’s not true. The exam may be the same for all students at the school and passing that exam may allow you to practice medicine, but doctors with accreditation from other states may or may not be recognized by that state. Doctors from foreign countries must pass the state’s licensing test. Unless something has changed recently, the AMA still retains a part in creating the state exams.
Yup, he was scum (if true) doesn’t justify murder.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.