Discover and read the best of Twitter Threads about #PBMs
Most recents (13)
So what are #PBMs? Chances are, if your meds suddenly got changed by your insurer, or you’ve been waiting weeks on #priorauth for a med you need, or you pay $$$$$ for a drug in the US that is cheap overseas, you’ve already experienced a #PBM and didn’t even know… twitter.com/i/web/status/1…
That’s b/c #PBMs aren’t meant to be known, they’re meant to be a middleman in healthcare cutting in an extra layer of profit for them and an extra cost to you…wonder why #prescriptiondrug pricing makes no sense compared to prices in other countries? This is why.
Pharmacy Benefit Managers (PBMs) are third party entities paid by healthcare insurance companies to manage all things meds: the formulary (what is/isn’t covered), the price from manufacturer, and the cost (copay or “tier”) to the patient.
I continually see research papers and presentations given on how #childhood #trauma relates to likelihood of #chronicpain.
While I do not dismiss this may be a factor, I am very frustrated at the lack of introspection by many #physicians where #medicaltrauma due to care that 1/
While I do not dismiss this may be a factor, I am very frustrated at the lack of introspection by many #physicians where #medicaltrauma due to care that 1/
🧵#OurAMA finds widespread lack of competition in local markets across US where #PBMs provide services to commercial health insurers.
First analysis to examine variations in market shares/competition among PBMs at state/metropolitan levels.
Read: tinyurl.com/bdf8m258
First analysis to examine variations in market shares/competition among PBMs at state/metropolitan levels.
Read: tinyurl.com/bdf8m258
2/ AMA’s competition analysis presents national and local market insight on 5 different #PBM services performed for insurers:
•rebate negotiation
•retail network management
•claim adjudication
•formulary management
•benefit design
Read report here: ama-assn.org/system/files/p…
•rebate negotiation
•retail network management
•claim adjudication
•formulary management
•benefit design
Read report here: ama-assn.org/system/files/p…
3/ @AmerMedicalAssn President @JackResneckMD said:
“The AMA already has serious concerns about #PBM business practices that can have a detrimental impact on patients’ access to and cost of prescription drugs.”
“PBM markets require careful scrutiny…” See👇
“The AMA already has serious concerns about #PBM business practices that can have a detrimental impact on patients’ access to and cost of prescription drugs.”
“PBM markets require careful scrutiny…” See👇
#BREAKING: @FTC launches inquiry into prescription drug middlemen industry. Agency to scrutinize impact of vertically integrated Pharmacy Benefit Managers on the access and affordability of medicine: bit.ly/3mlNH1J #PBMs /1
FTC will launch an inquiry into the prescription drug middleman industry, requiring the 6 largest #PBMs to provide information and records regarding their business practices. /2
Agency will send compulsory orders to CVS Caremark; Express Scripts, Inc.; OptumRx, Inc.; Humana Inc.; Prime Therapeutics LLC; and MedImpact Healthcare Systems, Inc. #PBMs /3
🔥A must-read: @oncologyCOA report on #PBMs
Some takeaways:
“…PBMs make up an oligopoly of rich, vertically integrated conglomerates that routinely prey on health care practices, providers, and their patients.”
Some takeaways:
“…PBMs make up an oligopoly of rich, vertically integrated conglomerates that routinely prey on health care practices, providers, and their patients.”
2/ “PBMs have done this by overwhelmingly abusing their responsibility to protect Americans from this country’s drug pricing crisis, instead exploiting the opacity throughout the nation’s drug supply chain to enrich themselves.”
a 🧵Who has interest in #PBMs?
The AMA Foundation has a corporate donors circle that gives them 💵
Here is a pic of the 2018 donors.
Highlighted companies are or own PBM
Pink asterisks are large lobby groups (as is the AMA)
Purple dots are of interest
ama-assn.org/system/files/2…
The AMA Foundation has a corporate donors circle that gives them 💵
Here is a pic of the 2018 donors.
Highlighted companies are or own PBM
Pink asterisks are large lobby groups (as is the AMA)
Purple dots are of interest
ama-assn.org/system/files/2…
2/5 🧵Here's a list of grants received by AMA... Why does our government... @CMSGov give the AMA over $500,000 💵 in a year to"transform clinical practices"?
How's that transformation going?
(and why should AMA be able to lobby a government that gives them 💵?)
How's that transformation going?
(and why should AMA be able to lobby a government that gives them 💵?)
3/5 🧵Looks 👀to me as though the alliance of health policy has a fancy dinner and sponsors an event with AMA, also sponsored by Pharma, Insurance companies and big hospital system ascension.
Did we get that wrong?
More about the alliance of health policy....
Did we get that wrong?
More about the alliance of health policy....
Dear @OptumRx & @SanfordHealth you are NOT his #physician. You know nothing of his #health hx. Two years ago #Sanford #Bismarck #pain clinic pulled all #patients off #opioid #pain medications. This was not #patientcentered care, but care deemed appropriate BY administrators 1
Now @OptumRx & @SanfordHealth #insurance sending out letters re #opioid #pain #medications. My son had to move from a #Sanford clinic to another clinic due to #abandonment. Yep, abandonment. Plain & simple what you did was harmful & not based on #patients needs. You need 2
to look at research, that shows the harms of what u r doing. @SanfordHealth administration in Bismarck informed me 2 years ago when all #patients pulled off #opioids that it was the ‘national standard’ of care established by @CDCInjury @CDCDirector. The guidelines are NOT 3/
1. In today's op ed in @CourierTimes , The head of TRG healthcare tells us that #PBM provide better access at a lower price.
When you are done laughing, 🤣
read all his unsubstantiated claims here: theintell.com/story/opinion/…
When you are done laughing, 🤣
read all his unsubstantiated claims here: theintell.com/story/opinion/…
2. I am so glad to learn more about TRG healthcare
They help to create Mergers and consolidations
with places like @BeaumontHealth
Read more here: trghealthcare.com/services/align…
They help to create Mergers and consolidations
with places like @BeaumontHealth
Read more here: trghealthcare.com/services/align…
3. Patients DO NOT use BIG #PBMs + mail order for affordability and ease.
They use them because the BIG PBM are merged with the insurance and the mergers themselves leave patients with few choices and damaged goods. TY @CynthiaMcFadden @NBCNews nbcnews.com/specials/milli…
They use them because the BIG PBM are merged with the insurance and the mergers themselves leave patients with few choices and damaged goods. TY @CynthiaMcFadden @NBCNews nbcnews.com/specials/milli…
I want to again express my concern to my senators @SenJohnHoeven and @kevincramer about the lack of transparency by the @CDCDirector @CDCInjury in the revising of the #OpioidGuidelines. Great harm has been done to those w #chronicpain in our state. @SanfordHealth 1/
cut all #patients off of #opioids at once due to what administration stated was because of ‘national standard’ (#CDC Guidelines). So many harmed. How are actions like this ok? Three weeks prior to my son being removed from #opioid #pain medications we had met with his 2/
#pain physician & had a long talk about #opioid #pain #medications being best option for him. Removing individuals w #chronicpain from #opioid pain medication was not a decision based on individual care of #patients BUT @SanfordHealth taking care of own needs. Multiple 3/
📄📄New article in @JAMAHealthForum 📄📄
We take a deep dive into the question of how to estimate rebates and other discounts received by Medicare #PartD.
With @bnrome, #VeroniqueRaimond, #JoshGagne, @akesselheim @PORTAL_Research
Thread below.
ja.ma/3z5mAx6
We take a deep dive into the question of how to estimate rebates and other discounts received by Medicare #PartD.
With @bnrome, #VeroniqueRaimond, #JoshGagne, @akesselheim @PORTAL_Research
Thread below.
ja.ma/3z5mAx6
Day one today of @OversightDems #drugprices hearing at 10amET: $BMY & its Celgene unit & $TEVA.
oversight.house.gov/legislation/he…
Also, at 11:30amET, @EnergyCommerce #COVID19 #vaccines hearing: energycommerce.house.gov/committee-acti…
oversight.house.gov/legislation/he…
Also, at 11:30amET, @EnergyCommerce #COVID19 #vaccines hearing: energycommerce.house.gov/committee-acti…
.@RepMaloney notes that anyone in the @OversightDems room not wearing #masks will not be recognized at today's #drugpricing hearing.
#drugprices $BMY $TEVA
#drugprices $BMY $TEVA
.@RepMaloney starts out playing clip of @RepCummings, who died last year before he could convene today's #drugpricing hearing.
He notes #pharma one of most powerful/profitable industries in the world.
#DrugPrices #pharma #biotech
He notes #pharma one of most powerful/profitable industries in the world.
#DrugPrices #pharma #biotech
#PainAwarenessMonth
#Pain impacts all areas of ones lives. It’s difficult to address. The current climate around those with #chronicpain is full of stigma & biases. The narrative that #opioids are bad & do not assist those w #pain or that there are a plethora of non-opioid 1/
#Pain impacts all areas of ones lives. It’s difficult to address. The current climate around those with #chronicpain is full of stigma & biases. The narrative that #opioids are bad & do not assist those w #pain or that there are a plethora of non-opioid 1/
continues to impact those that have #chronicpain negatively. IF you have #chronicpain you are acutely aware that care for those in #pain is poor in the USA. There may be ‘pockets’ where one can access superb care but I believe it is few & far between. We did NOT need the #CDC 2/
guidelines. They were Honecker by an ‘expert’ group whose sole focus was on #SUD NOT the treatment of pain. I believe they took the guidelines and encouraged the misapplication of these guidelines. Instead work should have been done to focus on better treatment options 4 those 3/
I am truly sick upon reading of this senseless tragedy. A #family #physician killed by one of his #patients in #Alberta #Canada. In the #USA we have a broken #healthcare system; #physicians overworked, they are often being dictated the care 1/ todayville.com/community-rais…
they are able to provide to #patients due to outside influences such as administrators, #insurance,#PBMs, politicians & #government. There is concern by #patients & #caregivers re care received this is particularly true w inds that have #complexhealth, #chronicillness & 2/
#chronicpain. Many #patients lives harmed due to #abandonment of care. Our #healthcare system is broken. We are seeing #physcians die by #suicide & #patients being harmed. These issues MUST be addressed! I truly believe that as a #patient #advocate it is also 3/
