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

Posted on December 14, 2022 by Dr. Marcinko

By Staff Reporters

***

***

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 »

What is the “Good-Rx” Business Model?

Posted on November 14, 2022 by Dr. Marcinko

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

***

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.

COMMENTS APPRECIATED

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***

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Filed under: Drugs and Pharma, Health Economics | Tagged: Good Rx, PBM, Pharmacy Benefits Managers | 3 Comments »

PHARMA: Will Americans Finally See Drug Prices Decrease?

Posted on November 4, 2022 by Dr. Marcinko

By Health Capital Consultants, LLC

***

***

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…)

COMMENTS APPRECIATED

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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. Marcinko

***
PHARMACY BENEFITS MANAGER

By Eric Bricker MD

***

***

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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: How Prescription Drug Coverage Really Works

Posted on March 20, 2022 by Dr. Marcinko

By Eric Bricker MD

***

***

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***

DICTIONARY HEALTH INSURANCE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4


***

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Filed under: Drugs and Pharma, Experts Invited, Health Economics, Health Insurance | Tagged: drug rebates, Drugs, Formulary, Health Insurance, PBMs, pharmacy, Pharmacy Benefits Managers, prescription drugs, tier one drugs, tier two drugs | Leave a comment »

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

Posted on January 23, 2022 by Dr. Marcinko

By Staff Reporters

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

****

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

***

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***

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 »

On PBM Business Practices

Posted on April 18, 2019 by Dr. Marcinko

Unfair -OR- Not?

[By staff reporters]

PBMs, like Prime Theraputics, Optum, CVS/Caremark, Walgreens/prime Mail and Express Scripts, Bring no value but huge expense to pharmaceutical medication prices.

The Trump administration and Congress must repeal the GPO and PBM safe harbor that allows them to extort pharmaceutical manufacturers to the tune of $200 billion a year.

***

***

Assessment:

Your thoughts are appreciated.

Product DetailsProduct Details

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Filed under: Drugs and Pharma, Health Economics, Health Insurance | Tagged: PBMs, Pharmacy Benefits Managers | 1 Comment »

On Rx Patient Non-Adherence

Posted on July 6, 2016 by Dr. Marcinko

Join Our Mailing List

By http://www.MCOL.com

A Picture of Poor Health and Opportunity for Retail Pharmacy and Pharmacy Benefits Managers [PBMs] 

***

drugs

***’

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***

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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