DAILY UPDATE: Independent Pharmacies Struggle as Stocks Hit New Highs

By Staff Reporters

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Independent pharmacies have struggled in recent years to stay open—and new financial constraints may mean a record number of pharmacy closures in 2024. And, nearly a third of independent pharmacies are at risk of going out of business due in part to a new rule from the Centers for Medicare and Medicaid Services (CMS) that results in lower prescription reimbursements, according to the National Community Pharmacists Association (NCPA), a trade group that represents more than 19,400 US pharmacies.

“This is an emergency,” NCPA CEO B. Douglas Hoey said in a statement. “If Congress fails to act again, thousands of local pharmacies could be closed within months and millions of patients could be stranded without a pharmacy.” The CMS rule, which went into effect on January 1st, requires payers and pharmacy benefit managers (PBMs) to apply what’s called direct and indirect remuneration (DIR) fees at the time a patient picks up a prescription.

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Here’s where the major benchmarks ended:

  • The S&P 500 index added 44.91 points (0.9%) to 5,248.49; the Dow Jones Industrial Average climbed 477.75 points (1.2%) to 39,760.08; the NASDAQ Composite added 83.82 points (0.5%) to 16,399.52. 
  • The 10-year Treasury note yield fell four basis points to just under 4.2%.
  • The CBOE Volatility Index® (VIX) dropped 0.48 to 12.76.

In addition to utility stocks, real estate, industrials, and materials were the strongest sectors. Information technology and communications were the weakest but found late-day strength to finish higher.

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DAILY UPDATE: Apple Credit Card, Drug Prices and the Modest Stock Markets

By Staff Reporters

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Apple is pulling the plug on its credit card partnership with Goldman Sachs Group, the Wall Street Journal reported on Tuesday. The tech giant recently sent a proposal to the Wall Street bank to exit the contract in the next 12 to 15 months, the report said, citing people briefed on the matter.

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Senators Elizabeth Warren (Democrat) and Mike Braun (Republican) sent a letter to the US Department of Health and Human Services last week, asking it to investigate whether large insurance companies are hiking prescription drug prices at pharmacies they own

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Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was up 4.46 points (0.1%) at 4,554.89; the Dow Jones Industrial Average was up 83.51 points (0.2%) at 35,416.98; the NASDAQ Composite® (COMP) was up 40.73 points (0.3%) at 14,281.76.
  • The 10-year Treasury yield was down about 6 basis points at 4.33%.
  • The CBOE® Volatility Index (VIX) was little-changed at 12.69.

Semiconductor and transportation shares were among the weakest performers Tuesday, and regional banks were also under pressure. Small cap stocks also lagged. The Russell 2000® Index (RUT) fell about 0.4% for its lowest close in a week.

Retailers and utilities were among the firmest sectors. In other markets, the U.S. Dollar Index (DXY) weakened to its lowest level since mid-August, reflecting expectations that U.S. interest rates have peaked.

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DAILY UPDATE: Thanksgiving Travel Gas Prices Down – Narrow Traffic Lanes Safer – Walgreens Pharmacies Closed as the Stock Markets Roar

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Thanksgiving is a trading holiday. Both the New York Stock Exchange and the Nasdaq are closed. Black Friday, one of the biggest shopping days of the year, is a half day for the stock market. Both stock exchanges close at 1:00 p.m. ET, with eligible options trading until 1:15 p.m. Normal trading hours resume on the Monday after Thanksgiving, also known as Cyber Monday, when many online retailers host major sales.

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Thanks to plummeting prices at the pump, US drivers will save a collective $1.2 billion this Thanksgiving travel period, and day, compared to last year, according to GasBuddy. The average price per gallon is down nearly 46 cents from a year ago, and more than 50,000 stations now show gas prices at $2.99/gallon or less.

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Narrow traffic lanes are safer than wide ones. Researchers at Johns Hopkins analyzed more than 1,000 streets in seven major cities across the US and found that narrower roads mitigated traffic collisions in certain conditions. The study did not find a significant difference between roads 9-feet wide and those 10- or 11-feet wide, but it did conclude that traffic accidents increase 1.5x when a road widens from 9 feet to 12 feet. Traffic fatalities are the leading cause of death for Americans aged 1–54.

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Walgreens will close most of its pharmacies and stores on Thanksgiving Day for the first time in the company’s history, executives said last Thursday. The move to close more than 8,700 stores for the federal holiday comes as some Walgreens workers staged a three-day walkout this fall to push for improved working conditions and increased staffing numbers, Reuters reported.

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Here is where the major benchmarks ended on Wednesday:

  • The S&P 500 Index was up 18.43 points (0.4%) at 4,556.62, near a four-month high close; the Dow Jones Industrial Average®(DJI) was up 184.74 points (0.5%) at 35,273.03; the NASDAQ Composite was up 65.88 points (0.5%) at 14,265.86.
  • The 10-year Treasury note yield (TNX) was down about 1 basis point at 4.41%, after earlier dropping to a two-month low under 4.37%.
  • CBOE Volatility Index (VIX) was down 0.50 at 12.85.

Communications services and technology were among the strongest performers Wednesday. Food and beverage companies were also firm. Energy shares were among the weakest performers Wednesday behind a drop of over 1% in WTI Crude Oil futures (/CL). ), which fell following reports OPEC delayed a weekend meeting until November 30th, a possible reflection of cartel members struggling to reach consensus over production cuts. WTI crude ended just under $77 a barrel, down 19% from a 2023 high above $95 in late October.

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PHARMACIES: Consumer Centric in the Future?

By Staff Reporters

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Rina Shah has been working at Walgreens her entire career—close to 25 years—but this year she got a shiny new title: vice president of pharmacy of the future. The role was created as part of what CEO Rosalind Brewer said in Walgreens’ latest earnings call is the company’s top priority: creating a consumer-centric healthcare company. The retail pharmacy giant essentially wants to free up its pharmacists’ time so they can go from filling prescriptions all day to engaging more directly with patients.

Shah is heading up these efforts, and she sat down with Neal Feyman to talk about what Walgreens sees when it pictures the pharmacy of the future.

What does “the pharmacy of the future” mean? When we talk about the future of pharmacy, it’s to leverage our pharmacists in a much more data-driven, effective way to lower costs in the system.

For example, in certain states where there’s higher pollen counts and pollution, we’re seeing higher emergency room visits because of asthma. We can educate people on the difference between a rescue inhaler and a maintenance inhaler—and how they can understand triggers—and ultimately impact lower emergency room visits because of that.

What problems are you trying to solve in this role? Prior to the pandemic hitting, we had been asked by providers and payers and other organizations for our pharmacists to do more. We were being asked to provide testing services and in-depth consultations with patients.

However, our operating model didn’t really account for that. Our pharmacists were busy doing many more administrative tasks. We made the decision that we needed to transform the model, which meant really freeing up the capacity of our pharmacists so they could spend time with patients delivering care, as it’s always intended to be. Keep reading here.—NF

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Pfizer’s Latest Twist on ‘Pay for Delay’

Protecting Brand-Named Drugs

By Marian Wang
ProPublica, November, 14th, 2011, 2:41 pm

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Pharmaceutical companies have sought for years to protect their expensive brand-name drugs by paying generic rivals [1] handsome sums of money to put off efforts to introduce cheaper, generic alternatives that could steal market share.

Pay for Delay

The controversial practice, known as “pay for delay,” occurs as part of patent litigation settlements and typically buys a brand-name drug company more time to sell its blockbuster drug exclusively until its patent on the drug expires. Federal Trade Commission regulators have said the practice costs consumers an estimated $3.5 billion each year [2], and have pushed for a ban.

But now it appears the drug company Pfizer is adding yet another twist to its efforts to delay generic competitors. As The New York Times reports, the company seems to have struck a deal with certain pharmacy benefit managers — the middlemen in the pharmaceutical industry — to block generic versions [3] of Lipitor.

The Block Buster

Lipitor, Pfizer’s blockbuster cholesterol-lowering drug, is among the world’s best-selling pharmaceuticals, and this isn’t Pfizer’s first attempt to protect it.

In 2008, the company settled patent litigation [4] with Ranbaxy, an Indian generic manufacturer, striking a deal that guaranteed that Pfizer would not have to face challenges [5] from Ranbaxy’s generic version of Lipitor until the end of November 2011. Pfizer granted Ranbaxy some incentives [6] as part of the bargain but said it made no payments. Nonetheless, a group of pharmacies filed suit [7] against Pfizer and Ranbaxy last week over the deal, calling it “an extraordinary ripoff” and alleging price-fixing between the two companies.

Big Discounts

Now that it’s November 2011, Ranbaxy and other drugmakers are gearing up to offer cheaper versions of Lipitor. As The Times reports [3], Pfizer has tried to counter this competition by offering big discounts on Lipitor to the middlemen that process prescriptions [8] for pharmacies and other buyers, giving them discounts in exchange for having them block generic versions of Lipitor for another six months. Here’s The Times:

Many drugstores are being asked to block prescriptions for a generic version of Pfizer’s Lipitor starting Dec. 1, when the company loses its patent for the blockbuster cholesterol drug and generic competition begins.

Medco Health Solutions, among the nation’s largest pharmacy benefit managers, is one of the companies issuing instructions, seeking to have pharmacists keep filling prescriptions with the more expensive Lipitor for six months.

See some of those instructions [9] sent to pharmacies by the pharma middlemen. The documents were released by Pharmacists United for Truth and Transparency, a group of independent pharmacists. (We first noticed them posted at the blog Pharmalot [10].)

According to the group, Pfizer’s plan would mean that customers at the pharmacies serviced by these middlemen would receive Lipitor even when they’ve been prescribed a generic version. Because Lipitor co-pays would also be reduced to the level of generic co-pays, customers might not notice, but employers and Medicare Part D would pay the same amount as before, despite the availability of a cheaper alternative.

Assessment

A Pfizer spokesman gave The Times a statement saying that the company was committed to ensuring that customers had access to Lipitor but declined to answer additional questions. We’ve also asked Pfizer for comment and will update when we hear back.

Conclusion

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