PBM Reform Podcast

Pharmacy Reimbursements Impact on Public Health | PBM Reform Podcast Series

The seventh episode in the PBM Reform Podcast Series features guest host Monique Whitney, the Excutive Director of Pharmacists United for Truth and Transparency (PUTT) interviewing pharmacy owners, Oliver's Express Pharmacy Oliver Lackey, PharmD and Main Street Pharmacy Owner, Jeremy Counts, PharmD. 
Two major trends are driving decreasing reimbursement to pharmacies: DIR fees and copay clawbacks. Direct and indirect remuneration (DIR) fees imposed on community pharmacies, sometimes weeks or months after a medication is dispensed, can eat up the pharmacy’s profit on a prescription transaction, and sometimes even lead to a loss.
According to a survey by the National Community Pharmacists Association (NCPA), 53 percent of pharmacists said DIR fees are assessed quarterly; 67 percent of those surveyed said no information is given as to how much and when DIR fees will be collected or assessed. DIR fees began when Medicare Part D was established, but they now appear in many commercial health insurance plans as well.
Episode & Summary sponsored by RxSafe
https://rxsafe.com/declining-reimbursement-the-facts/ 
Sponsored by the UltiGuard Safe Pack 
https://www.ulticare.com/ultiguard-safe-pack/podcast 
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The Unregulated PBM is a Danger to Public Health | PBM Reform Podcast Series

Pharmacists are trapped in a system that threatens patient safety.
Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA APhA Executive Vice President and CEO writes: If you ask me what keeps me up at night, I’d say it’s the kinds of mistakes that Ellen Gabler described in her January 31 New York Times story, “How Chaos at Chain Pharmacies Is Putting Patients at Risk.”  During my time as a community pharmacist, I cherished the relationships I established with patients and understood the great responsibility that came with the trust they placed in me.
Pharmacists take an oath to, among other things, “assure optimal outcomes” for patients. I can attest to the emphasis our profession places on patient safety. When it comes to medication-related errors, even one is too many.  Unfortunately, the current system sets pharmacists up to fail, and in turn, pharmacists are burning out at high rates.
This is an issue that not only puts patients at risk but deprives pharmacists of the opportunity to provide the kind of patient care we all got into pharmacy to provide. You can see it in the desperate pleas for change to state boards of pharmacy Gabler highlighted in her story. And we’re seeing it in the responses to those who have taken our Well-being Index for Pharmacists: The weight of the potentially dire consequences of filling the wrong prescription or missing dangerous drug interactions is crushing too many pharmacists. 
Special Guest:
Mike Schwab Executive Vice President
North Dakota Pharmacists Association
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A Pharmacy Owner’s Perspective | PBM Reform Podcast Series

On the 5th interview of the PBM Reform Podcast Series we talk with Scott Pace, Pharm.D., J.D. pharmacy owner and advocate for PBM Change. 
Scott is a Partner at Impact Management Group where he focuses on the Government Relations and Public Affairs practice areas.  
Scott joined IMG following more than 12 years with the Arkansas Pharmacists Association, most recently serving as the organization’s Executive Vice President and CEO.While at the APA, Pace successfully worked with the legislature to pass scope of practice legislation for pharmacists, legislation to amend the Arkansas Constitution to require a pharmacist consultant be a part of the Arkansas medical marijuana dispensaries, and most recently he worked with Governor Hutchinson and the legislature to pass legislation to license and oversee pharmacy benefits managers (PBMs) in Arkansas.
Scott is a licensed pharmacist and attorney.  He holds a bachelor’s degree in biology from Arkansas State University, a Doctor of Pharmacy from the University of Arkansas for Medical Sciences and a Juris Doctorate with High Honors from the University of Arkansas at Little Rock William H. Bowen School of Law. He served as the consumer representative on the Arkansas State Medical Board from 2012-2015 and he serves on the Arkansas Prescription Drug Monitoring Program (PDMP) Advisory Panel.
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IN DATA WE TRUST: | PBM Reform Podcast Series

IN DATA WE TRUST
Special Guest: ANTONIO CIACCIA with 3 Axis Advisors. 
Born and raised in pharmacy, Antonio has been crawling around pharmacies his entire life.  After three years as a pharmacy technician and two years of pre-pharmacy curriculum, Antonio diverted course, graduating from The Ohio State University in 2007 with dual degrees in communications and political science before moving into the world of association management.
Thinking that pharmacy would be in his rear-view mirror forever, he ended up making his way back to his pharmacy home, heading up government affairs for the Ohio Pharmacists Association, a trade organization with a strong track record of advocating for drug pricing transparency. After years of studying the pharmacy marketplace, Antonio became increasingly perplexed and concerned as he saw drug costs spiking while payouts to pharmacies were declining. Knowing something was being lost somewhere in the middle of an ever-growing transaction, Antonio has spent years working to crack the drug pricing code and pull the rug out from what he believes is one of the most dysfunctional marketplaces in the world.
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The Impact on Employers & the Pass-Thru PBM Option | PBM Reform Podcast Series

On Part Three of the PBM Reform Podcast Series we talk with Mary Ellen S. Jones a PSEA UniServ Representative and Anthony J. Loiacono / Chief Executive Officer of Capital Rx, a pass-thru Pharmacy Benefit Management company. 
PSEA is 181,000 members strong – a community of education professionals who make a difference in the lives of Pennsylvania’s students every day.  
PSEA members are teachers, education support professionals, higher education staff, nurses in health care facilities, retired educators, and college students preparing to become teachers.  PSEA’s strength comes not only from our members, but from our beliefs, our values, and our passion. Every time we speak up for what we believe, we harness the power of collective action.
Anthony J. Loiacono / AJ is a successful entrepreneur, with over 20 years of experience in pharmacy benefits, finance, and software development. As the CEO of Capital Rx, his mission is to change the way pharmacy benefits are priced and administrated in the US. Prior to Capital Rx, AJ was a co-founder of Truveris, where he served for eight years as CEO, Chief Innovation Officer, and Board Member, leading the company to record growth (Deloitte FAST 500 and Crain’s Fast50). Prior to Truveris, AJ co-founded SMS Partners, a joint venture with Realogy (RLGY), and in 2010 exited the partnership with a buyout. In his first venture, AJ started Victrix, a supply chain consultancy, and successfully sold the company to Chrysalis Solutions in 2007. 
https://www.cap-rx.com/company#leadership-team 
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Pharmacists for Truth Transparency - PBM Reform Series Part Two - PPN Episode 906

Part Two of the PBM Reform Podcast Series features an interview with Monique Whitney, the Excutive Director of Pharmacists United for Truth and Transparency (PUTT). 
Pharmacists United for Truth and Transparency (PUTT) is a non-profit advocacy organization founded by independent pharmacists and pharmacy owners devoted to exposing the truth about the anti-competitive tactics of pharmacy benefits managers (PBMs). Known to most Americans as their "prescription drug benefit plan" provider, PBMs are in reality a $300 billion industry - giant corporate middlemen driving up the cost of medications with huge mark ups and commissions on every prescription covered under their "benefits plan." 
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Working with local and national traditional and digital media that includes The New York Times, USA Today, CBS News, Bloomberg, NBC Nightly News with Lester Holt and Business Insider, PUTT seeks to educate patients, lawmakers, health plan sponsors and the public about the deeply negative effects of the PBM industry on U.S. healthcare and the escalating price of prescription medications.
PUTT serves as an industry watchdog, collecting evidence of PBM fraudulent practices and abuse and using this information to educate and inform consumers, taxpayers, employers and health plan sponsors of the truth about the unregulated, unmonitored PBM industry. Through PUTT's efforts, PBMs have begun to experience greater public awareness and scrutiny of their actions and come under fire for questionable practices including the use of gag clauses at the pharmacy counter, gross over-billing of health plans (called "spread pricing"), forcing patients to use PBM-owned pharmacies instead of allowing patients to choose their own pharmacies and interjecting unnecessary bureaucratic practices such as prior authorizations between patients and their doctors in the matter of prescription refills.
Monique Whitney
Pharmacists United for Truth and Transparency
Monique@TruthRx.org
m. (505) 480-4150
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PBM Reform Series Part One: NCPA INSIGHTS - PPN Episode 902

Anne CassityVice President, Federal and State Government Affairs at National Community Pharmacists Association (NCPA) joins Todd Eury, CEO of the Pharmacy Podcast Network, on part one of the new series: 
PBM Reform Podcast Series 
Pharmacy benefit managers were created as middlemen to reduce administrative costs for insurers, validate a patient’s eligibility, administer plan benefits, and negotiate costs between pharmacies and health plans. Over time, PBMs have been allowed to operate virtually unchecked. A lack of transparency in PBM practices has led several states to implement licensure/registration, fair pharmacy audit, or generic drug pricing legislation to try to level the playing field for pharmacies and patients. 
NCPA: https://www.ncpanet.org/advocacy/state-advocacy/pbm-reform 
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