CVS is revamping the way it reimburses its pharmacies for prescription medications, a move that could make prescription drug pricing simpler and change how much consumers pay for their medicines.
The company said in an announcement Tuesday that its new pharmacy reimbursement model will bring more transparency to its drug pricing system. It’s a similar model to the one entrepreneur Mark Cuban is pushing with his Cost Plus Drugs company.
Currently, the prices customers pay for drugs and the payments pharmacies receive are largely determined by middlemen known as pharmacy benefit managers, which negotiate rebates from drug manufacturers to insurers. These complex reimbursement formulas aren’t directly based on what pharmacies spent to purchase specific drugs.
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The health system as whole is messed up.
Pharmacy seems to take it to the next level. I’m baffled how a coupon printed from some random website gives me a cheaper prescription than my generally good employer sponsored health insurance.
My doctor prints these coupons (no login just a regular website) at the visit and tells me to make sure my insurance is actually cheaper than this stupid piece of paper makes the drug. Wtf man, how did we get here?
The one sane spot is Costco. The drugs are always cheap there. It’s just Costco is a pain in the ass to get in and out of quickly.
Oh yes, because of certain cultures, I have to go and get drug tested once a month, and can’t get my prescription refilled unless I show up in person because I might sell my prescription.
Nevermind the fact that I can easily drop my intake and save pills every month and easily end up with a lot of pills that hold more street value in one pill than the entire bottle can cost me even without insurance. (I can get the entire bottle out of pocket for ~$7 [No insurance] and one pill is ~$10 on the street. Yay free market, eh?)
The GoodRX thing is completely dumb though and I agree with you on that. My doctor has fucking pamphlets for GoodRX though, no printing needed.
What’s really fucking stupid now though, that just baffles me. CVS no longer takes my STATE ASSIGNED MEDICAID COVERAGE. They simply refuse to take it. So I’ve had to end up with my prescriptions spread across 3 different pharmacies at this point since Rite-Aid is going tits-up.
All this and they are still trying to shove anti-depressants down my throat that have literally brought me to the edge of suicide, which in my current situation, is super dangerous because I don’t have any semblance of a support system.
Hotdog, soda and insulin combo: $1.50
My doctor prints these coupons (no login just a regular website) at the visit and tells me to make sure my insurance is actually cheaper than this stupid piece of paper makes the drug. Wtf man, how did we get here?
It’s because those sites sell your data that they get from processing the payment.
Obligatory “if you don’t pay for a service, you’re the product.”
Nope. In a bizarre twist, pharmacies PAY for the privilege of using a discount card to make your med cheaper. GoodRx charges the most that I am aware of, but these payments can be like $1-$7 paid to the coupon provider. The reason is, GoodRx advertised the lowest price they would accept to you, so they paid GoodRx for the advertisement that brought you in. While you are in they hope to make a profit in other ways, and may also be making a small profit still, despite the apparent 90% markdown.
The reason they cannot discount without the card is because they must have a “usual and customary” charge to start the negotiations with when they determine how much the insurance companies will pay. If they just discounted willy nilly, that would make the charge they started with wrong, which could be considered fraudulently representing their pricing.
Healthcare in America guys. It makes sense. Trust me, no better way could possibly be constructed.
Yes, but they’ve also sold the data in the past.
Glad to see the FTC take up this fight in any case.
Damn mark Cuban did a thing and now I’m gonna save money. Capitalism actually working as intended? Undercutting brought the price down
