Member News (회원동정)
August 21, 2018
To: Donald Trump, President
Secretary of Human Resources Dept Political leaders, Pharmaceutical leaders , CEOs of local state Pharmacy Association, Deans of the school of pharmacy in University and my honorable fellow pharmacist colleague members:
On today’s date of Aug 21, 2018, the fifty-nine years running of the De Soto Pharmacy in Canoga Park near northern Los Angeles had to close down. The owner said that Rent, Payroll, etc. costs all went up, however, prescription reimbursement has not been paying enough to cover these expenses. Many employees and longtime customers who had enjoyed a signature soda fountain taste like an oasis in this valley area will no longer to able to experience it. It is now gone forever due to our much higher costs.
As an independent pharmacy owner, I have been circulating these issues for keeping a better healthcare system or reform of our unbalanced system to our related political leaders, and our pharmaceutical leaders as well. We need to pay much better attention to this issue and strive to have a more secure business model as a caregiver pharmacy in our communities.
This is a very unfair charge back rule by the PBM (Medicare Insurance Company) and they took out the amount of 3-5% the amount they have been paid to the pharmacy. This means PBM calculates the percentage of non-compliance rates from high blood pressure, Diabetes, high lipid medication users and they draw back the calculated money, even on a good compliance rate they draw back anyway. I do not know how they established this unfair rule initially but I presume to know if we pharmacists are to keep maintaining patient compliance then eventually the patient will have to reduce visits to their Drs/hospitals, eventually to reduce healthcare costs. However, that is not true. Each independent pharmacy is losing $10,000 - &15,000 yearly for this reason. Political leaders should pass the bill we sent and return all the illegally corrected funds retroactively to the pharmacies.
I have been circulating this issue since 2013. Drug costs went up at an unreasonable percentage and therefore the Government had the burden of higher healthcare costs. Now in 2018, the drug cost has had another skyrocketing raise. It must be stopped immediately before we are not able to control it. One pill of pinworm medication (mebendazole) now costs $358.94 however it used to cost under a dollar 7-8 years ago. It is an outrageous cost increase and many more cases are in the same situation. I cannot understand why the generic medication prices have increased at such a skyrocketing level. It must be stopped for all generic drug price movements.
PBM paid medication cost:
Diabetes blood test strips are OTC, many different brand costs average up to $30.00 wholesale and $50.00 retail per 100 strip box. Now a special brand strip costs are $150.00 /100 strips. The patient should have the choice and select their favorite brand and favor price. However, PBM and manufacturers have a relationship and only cover the special brand for each Medicare plan. In this case, PBM would not pay enough for the special selected brand. For example, Freestyle strip cost is $138.00 per 100 strips, but PBM pays to a pharmacy $138.00 cost per 100 strips claim. After a PBM audit to pharmacy they charge back if the pharmacy does not provide the invoice for buying the special brand of strip. PBM took the expensive cost from GOV and favor from the manufacturer however, they give no profit to the independent pharmacy. There are many more items in the same situation - even pills or many expensive brands of insulin products.
Abusive pharmacy auditing:
Pharmacy audits are selected from a reasonable amount of prescription claims and check if the pharmacy dispenses it properly but these days PBM company requires 200 to 400 prescription copies and pick up signatures, invoices and want to see the wholesale items in each year. It’s fine but they charge back for each clerical error, such as different filling dates, quantities, refill errors, etc. They check the expensive prescriptions only and they charge back hundreds of thousands dollars for all the minor errors. It truly is an abusive and outrageous audit process against all of the independent pharmacies in our country. Each pharmacy has the right to maintain its professional judgement and continue to protect against small clerical errors being charged back from the PBM company. There are many items which play the cost by manufacturer and PBM so we should make them stop doing this unfair and wrongful business practice for the future good model of healthcare reform.
I have been practicing the pharmacy business since 1969 and I have always been proud of my profession as it has been a pleasure helping my patients. However, these days I do now feel so desperate about being able to stay in my profession because of the many unfair and greedy market changes. It looks like if I buy more at this high product cost, not only have I not made any profitable business but also I am being complicit in this bad business practice. Everyone pays close attention to the keeping of fair and balanced American Value standards.
Please help and save our small community of pharmacies and help us to continue serving our individual patients.
Thank you very much for your attention and God Blessed America.
Jae K. Shin, R. Ph. Jays Drug, 3170 W Olympic Blvd #D Los Angeles, CA 90006 Tel (323)810-3360 FAX (805)388-5889 e-mail: email@example.com
If you support this petition, Please fill out the following information and send to me via e-mail: firstname.lastname@example.org or fax 805-388-5889 or call 323-810-3360 Please send this letter to your friend.
Name of Company:
I will collect all your comment to my correspondence “SHIN365” and share it later with you. SHIN means Save Healthcare Ideally Nationwide, we need your support for establishing each state level 2 independent pharmacy owners, 2 students of pharmacy school, 2 political leaders. Please join either member or executive member. Thank you very much for your continue support.
Jae Shin R.Ph