Pharmacy Benefit Managers Improperly Reinterpret Medicare Rules For Financial Gain
By a
-- Click here to access the full White Paper, Pharmacy Benefit Managers'
Attack on Physician Dispensing and Impact on
CVS Caremark's Efforts to Restrict Access to Cancer Care.
After decades of classifying and paying claims for physician dispensing as "in-network," the PBMs are playing a dangerous game with patient care in order to capture revenue in the growing specialty drug market. Despite a strong record and data showing positive patient outcomes from physician dispensing, the nation's PBMs have begun a disturbing trend of systematically limiting patient access to outpatient medications from their dispensing physicians. Since 2011, PBMs have consolidated into just five major corporations that control 80% of the covered lives in
"During my 26 years as an oncologist, I have witnessed a vast improvement in the quality of life as cancer care has moved from the hospitals to physician offices, and now, to oral drugs patients can take at home," said
"Patients taking many of the newest and most-effective oral cancer drugs require careful monitoring by their physicians and pharmacists," said
As the White Paper notes, currently the only PBM that has stated its intention to restrict patient access to physician dispensing is CVS Caremark. Earlier this month COA submitted an appeal to CVS Caremark to delay or cancel their proposed action. The appeal stated that if CVS Caremark does not reverse its position, or the
The complete White Paper, entitled, Pharmacy Benefit Managers' Attack on Physician Dispensing and Impact on
Keywords for this news article include: Cancer, Therapy,
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