PBM

A Behemoth is Born

CVS bought Caremark Rx. Read this carefully: Caremark has been sold. More predictions come true, and the rapid acquisitions of specialty pharmacies continue at a dazzling level.

Caremark Rx, Inc., located in Nashville, Tennesee, is the nation’s second-largest PBM. Caremark Rx has recently approved a $27 billion takeover by CVS. The acquisition has created a behemoth with the power to define, redefine, and direct the nation’s pharmacy distribution system. CVS/Caremark will have combined sales of more than $80 billion and rank among the top 20 Fortune 500 companies. Express Scripts, the number three PBM in the country, attempted a hostile takeover of Caremark in 2006. What will Express Scripts do next? Who might they purchase instead?

It can’t be stressed more strongly: Hemophilia patients must follow the rapidly changing acquisitions to know where their health benefits and service will originate, how this will affect their treatment and care, and where their health dollars will be going. For now, it looks like a lot of healthcare dollars will go to Wall Street.

Why You Need to Know PBMs


This weekend I visited Cuyahoga, Ohio, near Cleveland, to speak at the Northern Ohio Hemophilia Foundation’s annual meeting. I am very grateful to Lynn Capretto, executive director, for inviting me. I was able to meet with about a dozen new families I had never met before. The weather was great, the turnout wonderful. Lynn and her team worked hard to make this a success.

My talk was on insurance (what else?) and it appeared much of the information I shared was new to these families, who listened with great attention. I was happy to know that all the families subscribed to the NOHF’s newsletter, as it’s very important that everyone these days get their local newsletter. Insurance is different from state to state and your local hemo org is the best place to get information about changes. But I was amazed that almost none of the families get HemAware, the NHF’s magazine. I urged them to sign up Monday, and of course, Monday is a holiday. Okay, make it Tuesday. If you are reading this and you don’t get HemAware, please sign up! Call 1-800-42-HANDI and get on the mailing list.

Well, the audience redeemed itself. Everyone knew what PBMs were and that’s good news. What I didn’t know, and wish I had, was that certain factor brands in Ohio are being considered for a PDL. Scary stuff! Don’t know what PDL is? For shame. Order our newsletter PEN and find out. You NEED to know!

We had a lot of laughs when I had to select the raffle winners (I say have to: Lynn volunteered me because if someone was upset that they didn’t win, they could blame me but so what? I’d be on the plane headed for Boston!). The winners? The delightful family who had been sitting right next to me all throughout the day: Chris and Renee LaBelle. Sharp, proactive and articulate. I couldn’t think of a better family to win a free trip to NHF this week in Philadelphia!

Well, I had another celebrity citing at the airport in Cleveland. I travel a lot, and now and then I bump into an odd assortment of celebrities. In the past this has included Richard Simmons, Paul Newman, Ben Affleck, Tony Robbins, Bo Diddley, and Jim Rice and Pedro Martinez (both formerly of the Red Sox). This time it was Erik Estrada. Remember him? The hunky cop in the 1980s show CHiPs? I was walking right behind him for a long while, not realizing who he was but noticing him nonetheless (celebrities somehow carry themselves differently!) and a woman cried out “It’s Erik Estrada!” I didn’t grab a photo as I am wont to do, to add to my “Wall of Fame” at home, but I do have a photo of me with Dan Holibaugh, a long-time friend, fellow parent and current employee of Matrix. Thanks to Matrix and Baxter for co-sponsoring my visit to Ohio, and to NOHF for a wonderful event.

Tune in this week to NHF in Philadelphia! I hope to have some spare time to blog!

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