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DRUG: Scheduling & Classifications with Examples

Posted on March 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

Drugs: (List of Schedule I-V Controlled Drugs)

By Staff Reporters

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Any discussion on narcotics, prescription drugs, or other controlled substances is usually peppered with the word schedule. One substance may be Schedule I, while another is Schedule II, III, IV, or V.

Drugs, substances, and certain chemicals used to make drugs are classified into five (5) distinct categories or schedules depending upon the drug’s acceptable medical use and the drug’s abuse or dependency potential. The abuse rate is a determinate factor in the scheduling of the drug; for example, Schedule I drugs have a high potential for abuse and the potential to create severe psychological and/or physical dependence. As the drug schedule changes — Schedule II, Schedule III, etc., so does the abuse potential — Schedule V drugs represents the least potential for abuse.

A Listing of drugs and their schedule are located at Controlled Substance Act (CSA) Scheduling or CSA Scheduling by Alphabetical Order. These lists describes the basic or parent chemical and do not necessarily describe the salts, isomers and salts of isomers, esters, ethers and derivatives which may also be classified as controlled substances. These lists are intended as general references and are not comprehensive listings of all controlled substances.

Please note that a substance need not be listed as a controlled substance to be treated as a Schedule I substance for criminal prosecution. A controlled substance analogue is a substance which is intended for human consumption and is structurally or pharmacologically substantially similar to or is represented as being similar to a Schedule I or Schedule II substance and is not an approved medication in the United States.

Schedule I Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote.

Schedule II Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are: combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin

Schedule III Schedule III drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are: products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone

Schedule IV Schedule IV drugs, substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Some examples of Schedule IV drugs are: Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol

Schedule V Schedule V drugs, substances, or chemicals are defined as drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Some examples of Schedule V drugs are: cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin

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Filed under: "Doctors Only", Drugs and Pharma, Glossary Terms, Health Insurance, Health Law & Policy, mental health | Tagged: controlled substances schedule, CSA, drug classifications, drug schedules, Drugs, health, PBM, PMBs, prescribed drugs, prescribed medicine, RPh, Rx, scheduled drugs | Leave a comment »

DAILY UPDATE: Pharmacy Schools and PBMs as Stocks Recover

Posted on February 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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One year after forming an alliance with pharmacy schools, Walgreens says it has taken steps to get more people interested in the profession and improve working conditions at the chain.

Walgreens announced the Deans Advisory Council last February, framing it as a collaboration with pharmacy schools to boost the number of students enrolling and address some of the broader issues in the industry, like burnout and declining reimbursements from pharmacy benefit managers.

CITE: https://tinyurl.com/2h47urt5

US stocks recovered from losses on Wednesday to close higher on the day. Earnings from Alphabet (GOOG, GOOGL) and AMD (AMD) fell short, but Big Tech got a boost from a jump in Nvidia (NVDA) shares.

The tech-heavy NASDAQ Composite (^IXIC) rose 0.2%, while the benchmark S&P 500 (^GSPC) added 0.4%. The Dow Jones Industrial Average (^DJI) led the gains, rising 0.7%, or more than 300 points.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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Filed under: Drugs and Pharma, Ethics, Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors | Tagged: DJIA, DOW, druggists, Drugs, FTC, health, healthcare, Marcinko, NASA, NASDAQ, news, PBM, PBMs, pharmacy, pharmacy schools, RPh, S&P 500, srug store, textbooks, TNX, VIX, Walgreen's, walgreens, WSJ | Leave a comment »

DAILY UPDATE: Medicare and PBMs as Markets Slither

Posted on January 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

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The S&P 500 (^GSPC) just capped its best first four trading days under a new president since Ronald Reagan’s first week in 1985. And, the week ahead will bring investors a deluge of news that will put that rally to the test.

Earnings from more than 100 members of the S&P 500 — highlighted by results from tech heavyweights Meta (META), Microsoft (MSFT), Apple (AAPL), and Tesla (TSLA) — are set for release, with Wednesday serving as the week’s busiest. Starbucks (SBUX), Exxon (XOM), and Chevron (CVX) are also set to report.

On this coming ednesday afternoon, the Federal Reserve will also announce its latest monetary policy decision, with the central bank expected to keep interest rates unchanged and investors focused on what Fed Chairman Jay Powell has to say about the balance of 2025.

Last week, the S&P 500, NASDAQ Composite (^IXIC), and Dow Jones Industrial Average (^DJI) each rallied during a holiday-shortened four day trading week. Over the last five days, the S&P 500 and Dow have gained more than 2.8%; the tech index is leading gains over that period, rising more than 3.1%.

Markets welcomed Trump’s initial days in office as limited news on tariffs steadied investors and a massive AI investment announcement helped boost tech stocks.

CITE: https://www.r2library.com/Resource

The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”

CITE: https://tinyurl.com/2h47urt5

Medicare and the Trump 2.0 Administration

People have been concerned about the future of Medicare for years. Now that Donald Trump has begun his second term in office, the question becomes: What will happen next?

According to the JAMA Network and ABC News, here are some predictions for what may come:

  • There will be greater price transparency: During his first term, Trump worked to make prices more transparent to both individuals and health care organizations. This may very well continue.
  • More emphasis on Medicare Advantage plans: Under Project 2025, it’s possible that Medicare Advantage plans will become the “default option for Medicare coverage.” This could lead to a privatization of the program.

Medicare’s future remains to be seen. For now, the best thing current and future retirees can do is keep an eye on their coverage options and costs.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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Filed under: "Ask-an-Advisor", Drugs and Pharma, Ethics, Funding Basics, Glossary Terms, Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors | Tagged: Apple, CVX, DJIA, DOW, Facebook, FTC, google, Marcinko, medicare, Medicare Advantage, medicasre C, Meta, microsoft, MSFT, NASA, NASDAQ, PBM, PBMs, S&P 500, textbooks, TNX, VIX, WSJ, XOM | Leave a comment »

DAILY UPDATE: PBM Mark-Ups as Stocks Waiver

Posted on January 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

***

Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

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SPONSORED BY: Marcinko & Associates, Inc.

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Daily Update Provided By Staff Reporters Since 2007.
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The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”

CITE: https://tinyurl.com/2h47urt5

The S&P 500 fell 0.2%. The NASDAQ 100 lost 0.7%. The Dow Jones Industrial Average slid 0.2%. A gauge of the “Magnificent Seven” megacaps slipped 1.9%. The Russell 2000 added 0.2%. The KBW Bank Index declined 0.2%.

The yield on 10-year Treasuries declined four basis points to 4.61%. The Bloomberg Dollar Spot Index rose 0.1%.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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Filed under: Drugs and Pharma, Ethics, Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors | Tagged: Caremark Rx, Cigna, Cigna Express Scripts, DJIA, DOW, drug mark ups, FTC, generic drugs, healthcare, Marcinko, NASA, NASDAQ, OptumRx, PBM, PBMs, S&P 500, textbooks, TNX, UnitedHealth, VIX, WSJ | Leave a comment »

DAILY UPDATE: PBMs and Healthcare A.I. as All Major Market Indexes Drop

Posted on December 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Stat: 97%. That’s how many healthcare leaders think A.I. will become important in healthcare over the next five years.

***

Pharmacy benefit managers (PBMs) are once again under pressure from federal leaders. A group of Democratic and Republican congresspeople proposed legislation that would attempt to prevent pharmacies from also owning PBMs. The three largest PBMs—CVS Health’s Caremark, Cigna’s Express Scripts, and UnitedHealth Group’s Optum Rx—currently operate pharmacies and administer more than 80% of the prescriptions in the US, and officials have linked this practice to drug price increases.

CITE: https://tinyurl.com/2h47urt5

US stocks fell across the board on Tuesday, with the Dow logging its biggest losing streak in 46 years. The Dow Jones Industrial Average (^DJI) finished the session down roughly 0.6%, registering its ninth straight day of losses. The last 9-day losing streak for the Dow was Feb. 1978. Prior to that, the index suffered an 11-day losing streak in 1974 and another in 1971.

The other major indexes dropped in tandem on Tuesday, with the benchmark S&P 500 (^GSPC) falling around 0.4% and the NASDAQ Composite (^IXIC) losing about 0.3% after the tech-heavy index closed at a record high on Monday.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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Filed under: "Ask-an-Advisor", "Doctors Only", Accounting, Drugs and Pharma, Ethics, Financial Planning, Funding Basics, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors | Tagged: AI, artificial intelligence, Artificial Intelligence Medicine, Caremark, Cigna, CVs, DJIA, DOW, drug prices, health, healthcare, Healthcare AI, Marcinko, NASDAQ, Optum Rx, PBM, PBMs, pharma, Pharmacy Benefits Managers, S&P 500, Technology, textbooks, TNX, UnitedHealth, VIX, WSJ | Leave a comment »

DAILY UPDATE: CVS Splits as Stocks Down in Slow Session

Posted on November 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

***

Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

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Daily Update Provided By Staff Reporters Since 2007.
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Among consideration for CVS is splitting up its assets: CVS Pharmacy, pharmacy benefit manager CVS Caremark, and insurance arm Aetna. The company has reportedly been in talks with bankers about the move, Reuters reported early this month.

CITE: https://www.r2library.com/Resource

STOCKS UP

  • Just as Nvidia will replace Intel, Sherwin Williams will replace Dow Inc. on the Dow (how embarrassing, getting kicked off an index you share a name with). Sherwin Williams popped 4.59%, while Dow Inc. fell 2.08%.
  • Chewy is also getting added to an index, replacing Stericycle on the MidCap 400. Shares rose 6.34%.
  • Peloton pedaled 3.59% higher on a double upgrade from Bank of America analysts, who like the bike company’s higher profit outlook and hiring of new CEO Peter Stern from Ford.
  • Yum! China, the company that operates Pizza Hut and KFC restaurants in China, climbed 7.12% after announcing that new store openings translated into better-than-expected revenue and earnings last quarter.

STOCKS DOWN

Nuclear energy stocks took a big hit today after the Federal Energy Regulatory Commission ruled that Talen Energy could not increase the amount of energy its nuclear plant in Susquehanna, PA, produces in order to power an Amazon data center. Talen fell 2.23%, Vistra Corp sank 3.18%, and Constellation Energy plummeted 12.46%.

  • Clinical data from a Viking Therapeutics trial shows its weight-loss pill is effective. Shares soared then sank 13.36% as investors took profits.
  • The New York Times dropped 7.71% thanks to slower subscriber growth last quarter.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) dipped 16.11 points (–0.28%) to 5,712.69; the $DJI dropped 257.59 points (–0.61%) to 41,794.60; and the $COMP lost 59.93 points (–0.33%) to 18,179.98.
  • The 10-year Treasury note yield (TNX) fell five basis points to 4.31%.
  • The CBOE Volatility Index® (VIX)edged up to 22.11, still below last week’s peaks.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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UNITEDHEALTHGROUP: Recent Pros and Cons of UNH

Posted on October 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

A class action lawsuit has been filed in Minnesota against UnitedHealth Group (NYSE:UNH) over allegations that the health insurer and its subsidiary, NaviHealth, used a faulty algorithm to deny rehabilitation care for Medicare Advantage beneficiaries. California-based Clarkson Law Firm filed the lawsuit in the U.S. District Court of Minnesota on Tuesday following an investigative report published by the health-focused news site Stat.

It alleges that UnitedHealth and its subsidiary, NaviHealth, used the computer algorithm named nH Predict to “systematically deny claims” of patients recovering from debilitating illnesses in nursing homes. According to the lawsuit, despite its 90% error rate, the company used the algorithm to deny claims, knowing that only 0.2% would appeal its decision. According to Stat, Humana (HUM), the nation’s second-largest player in the Medicare Advantage market behind UnitedHealth (UNH), also uses nH Predict. UnitedHealth (UNH) denied it used the NaviHealth predict tool to arrive at coverage decisions.

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Ironically, UnitedHealth’s (NYSE:UNH) Optum Rx unit announced plans to move eight insulin products to “preferred” status on formularies to further expand the number of patients benefiting from $35 or less monthly out-of-pocket costs for the lifesaving therapy.

Optum Rx, UNH’s pharmacy benefit manager (PBM), said that effective January 1, 2024, all short- and rapid-acting insulins will move to Tier 1 in commercial formularies, a list of drugs the company maintains to indicate coverage for insured patients.

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DAILY UPDATE: UnitedHealth Group and PBMs as Technology Stocks Soar

Posted on July 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

***

Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

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Here’s where the major stock market benchmarks ended:

The Cboe Volatility Index® (VIX) fell sharply to 14.91.

The S&P 500® index (SPX) rose 59.41 points (1.1%) to 5,564.41; the Dow Jones Industrial Average® ($DJI) climbed 127.91 points (0.3%) to 40,415.44; the NASDAQ Composite® ($COMP)jumped 280.63 points (1.6%) to 18,007.57. 

The 10-year Treasury note yield (TNX) added two basis points to 4.26%.

CITE: https://www.r2library.com/Resource

What’s up

  • Reddit was upvoted 5.30% on the news that the company has sealed a deal with five major US sports leagues.
  • Nvidia popped 4.76% on a report that the company is working on China-specific semiconductor chips that will sidestep US trade restrictions.
  • Mattel soared 15.10% after the company was approached with an acquisition offer from private equity firm L Catterton.
  • Tesla climbed 5.15% ahead of the EV maker’s earnings report after the bell.
  • AMC Entertainment Holdings leapt 5.31% following an announcement that the company will refinance its debt.
  • Iqvia Holdings jumped 9.30% after a meet-and-beat second-quarter earnings report.

What’s down

  • Crowdstrike withered another 13.46% as the fallout from what’s being hailed as the largest IT outage in history continues to punish the stock.
  • Trump Media & Technology Group dipped 0.83% during the trading session after President Biden’s announcement that he’s dropping out of the presidential race.
  • Verizon sank 6.04% after whiffing on its earnings report, missing on revenue thanks to customers holding on to their old phones for longer.
  • Ryanair crumbled 15.41% following an earnings report that revealed the company’s earnings after taxes sank an eye-watering 46% last quarter.
  • Starbucks dropped 3.43% on a report by the Wall Street Journal late last week that activist investor Elliott Investment Management has taken a stake in the coffee chain.

CITE: https://tinyurl.com/2h47urt5

The US House of Representatives Committee on Oversight and Accountability is holding a hearing tomorrow, bringing in PBMs from around the US to testify on “their role in rising healthcare costs.” The hearing comes soon after an FTC report found PBMs to have an “outsized influence” on drug pricing.

CITE: https://tinyurl.com/tj8smmes

The February cyberattack on a UnitedHealth Group subsidiary may have exposed the health data of one in three Americans, but the nation’s largest health insurance company by market cap and revenue returned to profitability in the second quarter, beating Wall Street expectations and reporting net income of $4.2 billion.

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PODCAST: CVS Corporate History

Posted on April 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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DAILY UPDATE: PBM Pricing Structure and UnitedHealth Cyber Fury as Stock Markets Tumble

Posted on April 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

***

Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

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Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 20224

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Pharmacy Benefits Managers often need more transparency regarding their pricing structures and the rebates they negotiate with drug manufacturers. Some argue that PBMs might receive hidden fees or undisclosed profits from drug manufacturers in exchange for favorable positioning on their formularies (lists of covered medications). This can be seen as a form of kickback, which is illegal.

CITE: https://tinyurl.com/tj8smmes

Lawmakers Express Fury Toward UnitedHealth in Change Attack Hearing on the fallout surrounding the unprecedented cyberattack on Change Healthcare in late February. Individuals representing the American Hospital Association, private cybersecurity groups and providers testified before members of the House Energy and Commerce Committee on April 16th to discuss the healthcare industry’s response to the attack and how the federal government should act.

CITE: https://tinyurl.com/2h47urt5

In March, the cyber criminal organization received $22 million in bitcoins, though UnitedHealth Group has not addressed whether the company paid the ransom. On April 15th, ransomware group RansomHub posted files on its dark web leak site comprising of personal and protected health information on patients whose data was taken in the hack. The files also include contracts and agreements between Change and its clients, marking the first time hackers have posted data from the attack.

CITE: https://tinyurl.com/tj8smmes

Source: Jakob Emerson, Becker’s Hospital Review

Stocks started the day strong yesterday but ended up slumping before the market closed as investors pulled back on tech stocks, including Nvidia. United Airlines took off after releasing a strong forecast for the year despite saying it took a $200 million hit because of Boeing’s troubles.

Here’s where the major benchmarks ended:

  • The S&P 500 index lost 29.20 points (0.6%) to 5,022.21; the Dow Jones Industrial Average declined 45.66 points (0.1%) to 37,753.31; the NASDAQ Composite dropped 181.88 points (1.2%) to 15,683.37.
  • The 10-year Treasury note yield (TNX) decreased more than 7 basis points to 4.585%.
  • The CBOE Volatility Index® (VIX) fell 0.20 to 18.20.

ASML’s slump helped send the Philadelphia Semiconductor Index (SOX) down 3.3% to its lowest level since late February. Transportation shares were also under pressure after trucking company J.B. Hunt Transport Services (JBHT) dropped 8.1% in the wake of disappointing quarterly numbers. Energy shares slipped as WTI Crude Oil (/CL) futures fell 3% to a three-week low. 

CITE: https://www.r2library.com/Resource

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PODCAST: CVS Health PBM Change Pricing

Posted on February 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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DAILY UPDATE: Consumer Spending Down While CVS Earnings Up

Posted on February 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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To See What’s Next For Consumer Spending, Take a Closer Look at High ...
  • Stat: 0.8%. That’s how much consumer spending fell in January 204—a much bigger dip than expected (CNBC).

CITE: https://www.r2library.com/Resource

CVS reported strong results for its healthcare segment in 2023, showing a 10.2% increase in revenue compared to the prior year. Still, executives lowered the segment’s 2024 guidance in anticipation of rising medical costs, according to earnings released this month.

Finally, the US stock market reopens today after the long weekend, and everyone’s still talking about the Magnificent Seven. That’s because, according to a new report from Deutsche Bank, profits at these seven tech giants are greater than the profits of all publicly traded companies in nearly every G20 country. And in terms of market value, they’d be the second-largest national stock exchange in the world. Goldman Sachs sees this party lasting all night: It raised its 2024 target for the S&P 500 for the second time.

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CVS PHARMACY: Rx Drug Price Overhaul

Posted on December 8, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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CVS is overhauling how it prices prescription drugs

In a recent announcement, the company CVS promised that its new model would be more transparent than the current setup, which prices drugs based on complex reimbursement formulas that can make the costs of prescriptions confusing for consumers.

CITE: https://www.r2library.com/Resource/Title/082610254

The new model, called CVS CostVantage, is based on a simple equation: Drugs will cost what CVS paid for them, plus a limited markup and a flat fee to cover the services of fulfilling the prescriptions. That’s similar to a plan proposed by billionaire Mark Cuban, founder of Cost Plus Drugs, to bring accountability to drug pricing in the US.

MORE: https://medicalexecutivepost.com/2022/06/23/mark-cubans-cost-plus-drugs-com/

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PODCAST: How PBMs Work -OR- Don’t Work?

Posted on November 15, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

“PRIOR AUTHORIZATION“

By Eric Bricker MD

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PODCAST: CVS Replaces it’s PBM

Posted on August 26, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

Existential Threat to Pharmacy Benefits Managers?

By Staff Reporters

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DEFINITION

PODCAST: PBM Money Flow Explained

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Just now, CVS got a taste of its own medicine after Blue Shield of California said it will replace CVS’s pharmacy benefit manager system [PBMs] with other companies, including Amazon Pharmacy and Mark Cuban’s Cost Plugs Drugs business, to supply cheaper drugs to its members.

CITE: https://www.r2library.com/Resource

The move poses an existential threat to the entire pharmacy-benefit manager model.

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DAILY UPDATE: Mark Cuban’s “Cost Plus Drugs” Company, Palintir and the Markets

Posted on August 10, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

Mark Cuban’s Cost Plus Drug Company has been on a partnering spree lately, and its latest collaborator is Scripta Insights, a digital health company that helps health plans and members find prescription savings.

Mark Cuban Launches Generic Drug Company

Scripta plans to incorporate Cost Plus Drugs’s discounted pricing into its Med Mapper, which “maps every drug on the market to every possible way to save,” according to Scripta.

MARK CUBAN’s: “Cost Plus Drugs”. com

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Palantir stock fell 11% to $15.25 yesterday, its biggest drop since November 2022. With that decline, shares are now below their 50-day moving average, at $16.16, for the first time May. It’s broken its uptrend line, which sat around $17, and its first level of support, near $16. Worse still, the stock has fallen for six straight days and is 22% during its losing streak, the worst six-day stretch since May 2022.

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Here is where the major benchmarks ended:

  • The S&P 500 Index was down 31.67 points (0.7%) at 4,467.71; the Dow Jones Industrial Average (DJIA) was down 191.13 points (0.5%) at 35,123.36; the NASDAQ Composite was down 162.31 points (1.2%) at 13,722.02.
  • The 10-year Treasury note yield (TNX) was down about 2 basis points at 4.004%.
  • CBOE’s Volatility Index (VIX) was little changed at 15.99.

Financial shares joined tech stocks in the laggard column Wednesday. The KBW Regional Banking Index (KRX) was down about 1%, while the Philadelphia Semiconductor Index (SOX) dropped about 1.4%. Energy stocks continued to outperform as crude oil futures gained nearly 2% and touched a nine-month high near $85 a barrel.

Oil’s recent rally reflects production cuts by top global producers and concern over supply disruptions stemming from the Russia-Ukraine war.

***

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DAILY UPDATE: FTC Blocks Amgen, CME Fed Watch and the Markets

Posted on May 17, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The Federal Trade Commission said on Tuesday [yesterday] it will try to block an effort by bio-pharmaceutical leader Amgen Inc. from purchasing Horizon Therapeutics for $28.3 billion, charging the move could force insurance companies to favor their products. The FTC said the coupling of Amgen and Horizon could have allowed Amgen to leverage its portfolio of top-selling drugs to entrench a monopoly position in treatments for thyroid eye disease and chronic refractory gout. The watchdog agency said Amgen could force insurance companies and pharmacy benefit managers, or PBMs, into favoring Horizon’s two monopoly products. It said Tepezza is used to treat thyroid eye disease, while Krystexxa is used to treat chronic refractory gout. The agency said neither of the treatments has competition in the pharmaceutical marketplace.

CITE: https://www.r2library.com/Resource

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And, the CME FedWatch Tool shows an 82% probability of the Fed leaving rates where they are, versus an 18% chance of another rate hike. As for rate cuts, Liz Ann Sonders of Schwab said they remain unlikely “unless the banking crisis significantly worsens and/or the economy or labor market sinks notably.” “Otherwise, the most likely outcome is for the Fed to pause and hold,” she added.

***

So, here is where the major benchmarks ended yesterday:

  • The S&P 500® Index was down 26.38 points (0.64%) at 4,109.90; the Dow Jones Industrial Average was down 336.46 (1.01%) at 33,012.14; the NASDAQ Composite was down 22.16 (0.18%) at 12,343.05.
  • The 10-year Treasury yield was up about 4 basis points at 3.541%.
  • CBOE’s Volatility Index was up 90 basis points at 18.02.

The energy sector was one of the weakest performers Tuesday, as WTI Crude Oil futures dipped. The Dow Jones U.S. Oil & Gas Total Stock Market Index was down more than 2%, while the S&P Global Oil Index shed 2.5%. Real estate and utilities also lagged. Communication services and tech were the strongest performers.

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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What is the “Good-Rx” Business Model?

Posted on May 16, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Anonymous

GoodRx Holdings, Inc. is an American healthcare company that operates a telemedicine platform and a free-to-use website and mobile app that track prescription drug prices in the United States and provide free drug coupons for discounts on medications. GoodRx checks more than 75,000 pharmacies in the United States

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Good Rx makes money by perpetuating the, artificially set, high sticker prices of medications and receiving a portion of Pharmacy Benefits Manager [PBM] fees.

How it Works

GoodRx taps into PBM network for their “discounts” off of sticker price (e.g. Express Scripts, Optum Rx, Navitus … etc)

Consumer pays the newly “discounted” drug price.

Pharmacy pays PBM fee.

PBM pays GoodRx portion of the fee.

Good Rx adjusted EBITDA in 2019: $160 Million

Good Rx 2020 revenue is up 48% first half of 2020 – $257M

IPO: https://mobile-reuters-com.cdn.ampproject.org/c/s/mobile.reuters.com/article/amp/idUSKBN24Y0N6

Opinion:

This is not market value.

This is another hand in the cookie jar keeping healthcare prices artificially high.

The consumer is the one ultimately harmed.

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DRUGS: Use and Abuse Epidemiology Information

Posted on February 24, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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“The staggering increase in methamphetamine-related deaths in the United States is largely now driven by the co-involvement of street opioids.”—Rachel Hoopsick, an assistant professor of epidemiology at the University of Illinois at Urbana-Champaign and lead researcher on a 20-year study (US News and World Report)

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How 3 companies came to dominate the PBM market

MORE: https://medicalexecutivepost.com/2022/09/21/podcast-pbm-money-flow-explained/

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More docs than ever use health IT for opioid prescribing

RELATED: https://medicalexecutivepost.com/2022/05/09/prescription-drug-rx-abuse/

LINK: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

***

Drug Econometrics

LINK: https://medicalexecutivepost.com/2016/11/06/are-soaring-health-care-costs-hurting-the-u-s-economy/

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ELIXIR: Rite Aid’s New PBM [mail order pharmacy]

Posted on December 14, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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When Rite Aid dropped roughly $2 billion in 2015 to buy its pharmacy benefit management (PBM) subsidiary now known as Elixir, the company had framed the investment as a strategic move to compete in the healthcare marketplace among rivals like CVS and Walgreens.

The deal quickly helped make Rite Aid $4.1 billion in its newly formed pharmacy services segment—including Elixir and other pharmacy services, according to the company—bolstering its financial standing the next fiscal year. Maybe it would no longer be the ugly duckling next to the cooler, sleeker swans.

It seemed to be working—for a while at least. But by 2018, analysts were recommending Rite Aid sell off Elixir to reduce the parent company’s debt. Still, Rite Aid stuck with Elixir in hopes of boosting its competitiveness in the retail pharmacy scene.

CITE: https://www.r2library.com/Resource/Title/082610254

This year, Rite Aid President and CEO Heyward Donigan was still painting a rosy picture of Elixir, saying in earnings calls that the PBM was gaining more members and Elixir’s operating margins were improving.

But a month after its latest earnings call in September, Rite Aid was hit with a class-action lawsuit accusing the company of making “false and/or misleading statements” to investors about Elixir’s status between April and September of this year.

READ: https://www.healthcare-brew.com/stories/2022/12/09/rite-aid-faces-a-class-action-lawsuit-over-its-pharmacy-benefits-subsidiary

***

ORDER: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

***

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Filed under: "Ask-an-Advisor", "Doctors Only", Drugs and Pharma, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Elixir, mail order pharmacy, order, PBM, pharmacy, Pharmacy Benefits Managers, Rite Aid, Rite Aid's PBM | Leave a comment »

PHARMA: Will Americans Finally See Drug Prices Decrease?

Posted on November 4, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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***

According to the White House, “Americans pay two to three times as much as people in other countries for prescription drugs, and one in four Americans who take prescription drugs struggle to afford their medications. Nearly 3 in 10 American adults who take prescription drugs say that they have skipped doses, cut pills in half, or not filled prescriptions due to cost.” In an effort to combat this growing crisis, both the federal government and private companies have taken a number of steps over the past year aiming to lower drug prices. This Health Capital Topics article will review those actions and the potential unintended consequences of these actions.
(Read more…)

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CITE: https://www.r2library.com/Resource/Title/082610254

ORDER: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

***

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Filed under: "Doctors Only", Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance | Tagged: drug prices, Drugs, Health Capital Consultants LLC, PBM, pharma, pharmacy, Pharmacy Benefits Managers, Will Americans Finally See Drug Prices Decrease? | Leave a comment »

PODCAST: PBM Money Flow Explained

Posted on September 21, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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PHARMACY BENEFITS MANAGER

By Eric Bricker MD

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COMMENTS APPRECIATED

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***

HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

***

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Filed under: "Doctors Only", Accounting, Career Development, Drugs and Pharma, Ethics, Events-Planner, Funding Basics, Health Economics, Videos | Tagged: Eric Bricker MD, PBM, PBMs, Pharmacy Benefit Mangers, Pharmacy Benefits Managers | Leave a comment »

PODCAST: Surescripts [Gatekeeper for Electronic Prescribing Explained]

Posted on August 4, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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COMMENTS APPRECIATED

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***

CITE: https://www.r2library.com/Resource/Title/082610254

DHIT: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

***

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Filed under: "Doctors Only", Career Development, Drugs and Pharma, Ethics, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Videos | Tagged: EHRs, electonic prescribing, EMRs, Eric Bricker MD, PBM, PBMs, Surescripts, Surescripts [Gatekeeper for Electronic Prescribing Explained] | Leave a comment »

Drugs, Money and the Middleman

Posted on March 14, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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PIPELINE TO PROFITS

A little more about that … Kaiser Health News infographic!

untitled

By Dr. David E. Marcinko MBA via Georgia Pharmacy Association

***

Recently, KHN ran an infographic from Kaiser Health News that gave a rough explanation of how the money flows in the sale of a brand-name drug.

After thinking about it a bit, Greg Reybold, Vice President of Public Policy & Association Counsel for the Georgia Pharmacy Association, noticed some fundamental flaws.

“The infographic helps shed light on a process that lacks fundamental transparency,” he said, “but it doesn’t reflect all of the practices engaged in by some PBMs.”

Furthermore, he added,

“There are times, unbeknownst to patients, when some PBMs charge patients copays that are significantly higher than the cost of the drugs themselves, or they steer patients to brand name drugs for which the PBM receives a rebate when there is a less costly generic available.”

He also noted the infographic:

“reflects that the pharmacy make a profit — when in fact there are many times pharmacies lose money on prescriptions they fill through low reimbursements, the imposition of different types of fees, and aggressive audits.”

http://www.gpha.org/

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Filed under: Drugs and Pharma | Tagged: cost of Rx drugs, Greg Reybold, KAISER HEALTH NEWS., PBM, Pharmacy Benefit Mangers | 3 Comments »

UPDATE: The Markets and is Billionaire Mark Cuban on [Rx] Drugs?

Posted on January 25, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Stock Markets: The major equity indexes staged a thrilling comeback to close solidly in positive territory. At one point, the NASDAQ was down nearly 5% and the S&P entered correction territory.

CITE: https://www.r2library.com/Resource/Title/082610254

***

Mark Cuban: The billionaire owner of the Dallas Mavericks just launched an online pharmacy for generic drugs that looks to cut out middlemen and combat pharmaceutical industry price gouging by offering steep discounts. Set up as CostPlusDrugs.com with 100 generic drugs to treat conditions like diabetes and asthma. Cost Plus will not accept health insurance but claims its prices will still be lower than what people would typically pay at a pharmacy. “All drugs are priced at cost plus 15%!” Cuban tweeted.

READ: https://medicalexecutivepost.com/2022/01/23/podcast-the-mark-cuban-cost-plus-drug-co-mccpdc/

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Subscribe to the Medical Executive-Post

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Filed under: Alerts Sign-Up, Glossary Terms, Health Insurance, Investing | Tagged: CostPlusDrugs.com, Drugs, Mark Cuban, NASDAQ, PBM, prescription drugs, stock markets | 1 Comment »

PODCAST: The Mark Cuban Cost Plus Drug Co (MCCPDC)

Posted on January 23, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

Mark Cuban, not Congress, will give Americans cheaper prescription drugs

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When universal health care fails to pass in Congress, there’s always Mark Cuban to fall back on. The billionaire and Dallas Mavericks owner launched an online pharmacy this week in order to combat the price gouging of prescription drugs by large pharmaceutical companies.

Citation: https://www.r2library.com/Resource/Title/0826102549

The Mark Cuban Cost Plus Drug Co. (MCCPDC) will offer more than 100 generic drugs that will be purchased directly from the manufacturers and sold online with a 15 percent markup across the board and a small pharmacist fee. For context, pharmaceutical companies generally mark prices up at least 100 percent and up to 1000 percent in some cases.

***

PBM Forum Wrap Up: Greater Transparency, Further Congressional Review  Needed to Lower Drug Prices - United States House Committee on Oversight  and Government Reform

***

READ: https://www.msn.com/en-us/money/other/its-quite-a-country-when-mark-cuban-not-congress-will-give-americans-cheaper-prescription-drugs/ar-AAT2KJ3?li=BBnb7Kz

***

COMMENTS APPRECIATED

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Subscribe to the Medical Executive-Post

***

PODCAST: Pharma Rebates to PBMs

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Filed under: Breaking News, Drugs and Pharma, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: Drugs, drugs costs, Eric Bricker MD, generic drugs, Mark Cuban, Mark Cuban Cost Plus Drug Co., PBM, Pharmacy Benefits Managers | Leave a comment »

PODCAST: What is a Medication Formulary?

Posted on January 13, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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About First Stop Health | Telemedicine

By Eric Bricker MD

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Why Are Certain Medications Non-Formulary?

What Are Formulary Tiers and Its Rules?

Formularies Have Many Rules Associated With Them:

1) Prior Authorization – Approval Must Be Given by the Health Insurance Company/PBM Before They Agree to Pay for a Medication.

2) Step Therapy – Certain Less Expensive Generic Medications Have to Be ‘Tried’ First and Fail Before a Doctor Can Prescribe a More Expensive Brand-Name Medication.

3) Mandatory Generics – If a Brand Name Medication Has A Direct Generic Equivalent, Then the Insurance May Only Agree to Pay for the Generic and Not the Brand.

4) Mandatory Mail Order – Certain Chronic Medications That Are Filled for 90 Day Supplies Must Be Filled via Mail Order and Not at the Retail Pharmacy.

***

PODCAST: https://www.youtube.com/watch?v=kEjDBp9HdBk

***

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HEALTH ECONOMICS CITE: https://www.r2library.com/Resource/Title/0826102549

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Filed under: "Advisors Only", Drugs and Pharma, Experts Invited, Videos | Tagged: brand name drugs, drug formularies, Drugs, Eric Bricker MD, Formulary, generic drugs, medications, PBM, Prior Authorization, Rx, step therapy | Leave a comment »

PODCASTS: How Prescription [Rx] Coverage Works

Posted on December 19, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

Formulary Tiers, PBM, Rebates, Spread-Pricing Explained

By Dr. Eric Bricker MD

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CITE: https://www.r2library.com/Resource/Title/082610254

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YOUR COMMENTS ARE APPRECIATED.

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Filed under: Drugs and Pharma, Experts Invited, Funding Basics, Glossary Terms, Health Insurance, Healthcare Finance, Practice Management, Videos | Tagged: Anthem, Caremark, Cigna, CVs, DEA, drug rebates, drug tiers, Drugs, Eric Bricker MD, Express Scripts, Formulary, Health Insurance, medications, Optum, PBM, PBMs, pharmacy, prescription coverage, Rx, spread drug pricing, UHC, United Health Care | Leave a comment »

PODCAST: Using “GoodRx” to Check Prescription Prices

Posted on August 18, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

BY ERIC BRICKER MD

YOUR THOUGHTS AND COMMENTS ARE APPRECIATED.

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CITE: https://www.r2library.com/Resource/Title/0826102549

***

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Filed under: Drugs and Pharma, Experts Invited, Videos | Tagged: Drugs, Eric Bricker MD, GoodRx, PBM, prescriptions, Rx | Leave a comment »

The PBMI Innovation Challenge

Posted on August 6, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

There’s still time!
Submit your innovative solution in patient health management to the Pharmacy Benefit Management Institute (PBMI) Innovation Challenge by August 6, 2021 for the chance to be among one of the 5 finalists selected to pitch their ideas before a panel of judges at the PBMI 2021 Annual Meeting!




Be sure to submit your idea by August 6, 2021 for the chance to be featured in an upcoming issue of Managed Healthcare Executive with a full-year integrated marketing program valued at over $100K, in addition to formal acknowledgment at this year’s PBMI Conference.

REGISTER: https://events.pbmi.com/event/31593a7e-d661-4ea5-abf2-5aa6473e1a14/summary

***

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Filed under: Drugs and Pharma | Tagged: Drugs, PBM, pharma, Pharmacy Benefit Mangers | 1 Comment »

PODCAST: PBM Formulary Waste Exposed in Commonwealth Fund Study

Posted on July 30, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

15 Self-Funded Employers Analyzed Their Pharmacy Claims Data in Conjunction with the Commonwealth Fund and Discovered the Following Regarding their PBM FormularIES

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YOUR THOUGHTS ARE APPRECIATED

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Click to access mike-stahl-phd-mba.pdf

***

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Filed under: "Doctors Only", Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance | Tagged: Eric Bricker MD, PBM, PBMs, Pharmacy Benefit Mangers | Leave a comment »

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