LANDMARK CASE UPDATE  
  RUTLEDGE v PCMA: A CLASSIC CLIFFHANGER  
 


As PUTT members and friends gathered online this past Tuesday to listen in on the Rutledge v PCMA Supreme Court case, the hearing's events played out like an old-time radio drama. Moments of hurrah for the Arkansas and U.S. Solicitor Generals quickly gave way to worry on some Justices' lines of questioning. The annoyance regarding statements made by the PCMA counsel was palpable - you could almost hear the suspense music playing in the background.

The proceedings themselves offered varying degrees of insight into the Justice's minds regarding the case. Our PUTT "Watch" Party call included discussion before and afterwards with Miguel Rodriguez, General Counsel for APRx who shed insightful, cautiously optimistic light on the day's questioning and arguments.

A decision is expected by mid-June 2021, and while speculation runs rampant, no one can predict which way the high court will decide. One thing is certain, the opinions written by each of the Justices will prove to be invaluable for future PBM reform.

Tell us what you thought! Email us here


To read Bloomberg's take on the proceedings click here.

To catch up on Rutledge v PCMA, listen to a live recording of the SCOTUS arguments, or hear our latest podcast discussion on the case click here.
 
  TAKING ON GOLIATH  
  A RAGIN CAJUN SHOWDOWN: LOCAL PHARMACIES FACE-OFF AGAINST CVS CAREMARK  
 
Randal Johnson, LIPA CEO testifying before the JLCB

For two weeks in a row, Louisiana independent pharmacies have challenged the state's Office of Group Benefits' (OGB) attempt to enact an "emergency" contract with CVS Caremark. The Joint Legislative Committee on the Budget (JLCB) held hearings to decide whether or not to approve the CVS Caremark contract instead of exercising a one year extension with the state's current provider, MedImpact. Ultimately, the JLCB voted 24-0 to reject the Caremark contract.

"The state appears focused on promised savings with little or no regard for how those savings would be achieved and who would be driven out of business as a result," said LIPA CEO Randal Johnson. "With the proposed emergency contract being one-year and the state already expressing its desire to enter into a regular contract with CVS for up to five years, we are looking at as many as 6 years of added struggle for local pharmacies who seek nothing more than the opportunity to serve patients on a fair and level playing field."

The hearings were attended by pharmacists from across the state who voiced opposition, and while Caremark did come to the negotiating table between hearings, their concessions to the contract language changes were common sense at best -- including the inclusion of Act 124 language, Louisiana's 2019 PBM reform law.

"If you look at that legislation," said Johnson in his testimony, "we appreciate the fact that it was adopted in the contract. We regret the fact that there wasn't an admission on a contract by the state of Louisiana that 'we abide by the laws of the state of Louisiana' to start with."

To watch the JLCB hearing in its entirety click here
 
  STAYING INFORMED  
  NEWS & STORIES FROM ACROSS THE NATION  
 

Family-Run Pharmacies Cautiously Optimistic as Supreme Court Hears Case
October 7, 2020  Kings County Politics

Local family-run pharmacies are hopeful the United States Supreme Court will soon side with them an effort to support the rights of states to impose regulations on the Pharmacy Benefit Manager (PBM) industry.

"This case is about the legal mechanism that for too long has allowed pharmacy benefit managers (PBMs) to corrupt and degrade our prescription drug distribution system with impunity. We are hopeful the United States Supreme Court will restore the right of states across the country to protect patients, taxpayers and pharmacies by reining in these corrupt, unregulated corporations," said Tom D'Angelo president of the Pharmacists Society of the State of New York (PSSNY).
Continue Reading


Giving Patients The Healthcare System They Already Think They Have
October 6, 2020  Cape Gazette

The COVID-19 crisis is a disturbing eye-opener for many Americans as they discover that the public health protections they have always believed were in place may not exist. This raises public awareness that long-held beliefs about our healthcare system - for example, that physicians and patients make the decisions on the best course of treatment - are, in fact, fallacies.

In too many cases, doctors are not in the driver's seat in deciding how to most effectively meet patients' needs. Physicians must navigate through a maze of barriers constructed by insurers and pharmacy benefit managers to prescribe the medicines physicians deem most suitable. Frequently, drugs are covered not on the basis of medical expertise, but rather on negotiated deals and high profit margins for certain medications. 
Continue Reading


Drugmakers, PBMs Must Jointly Face Insulin Price-Fixing Lawsuit, Judge Rules
October 2, 2020  Beckers Hospital Review

A lawsuit accusing several drugmakers and pharmacy benefit managers of conspiring to fix prices for insulin can proceed, a Texas judge ruled Sept. 29, marking the first time drugmakers and PBMs will have to collectively defend their role in the rising price of insulin, STAT reported. 

The lawsuit was filed in Harris County, Texas, in 2019 and claims taxpayers were "fraudulently overcharged" for drastic price hikes for insulin, a drug that hasn't changed substantively in many years. 

The lawsuit claims that from 2013 to 2018 Harris County had to pay $27.5 million for insulin due to an alleged pricing scheme involving drug companies and the country's largest PBMs: OptumRx, Express Scripts and CVS Caremark. No previous lawsuits on insulin prices have accused PBMs of collaborating with drugmakers to raise insulin prices, STAT reported. 

The companies named in the lawsuit face civil racketeering and fraud claims.  Continue Reading


Law That Helps Cancer Patients Goes Into Effect Thursday

September 30, 2020 The Robesonian

A new law to help improve North Carolina cancer patients' access to the most effective cancer treatments will take effect Thursday, the first day of Breast Cancer Awareness Month.

Senate Bill 361 was signed into law by Gov. Roy Cooper on July 1. The new law places limits on step therapy policies - also known as "fail first" - that require patients to try less expensive, potentially less effective drugs before they can get coverage for the prescriptions their physicians recommend.

The law marks a historic and life-saving measure for North Carolinians that will improve access to high-quality cancer care by eliminating delays to necessary treatment, according to the American Cancer Society Cancer Action Network, Inc.  Continue Reading


 
  NEWS YOU CAN USE  
  HELP YOUR PATIENTS NAVIGATE OPEN ENROLLMENT  
 
Medicare open enrollment begins on October 15th, and while many patients may be gun-shy of additional change in the wake of a tumultuous year, it's important that they review their plans to make sure they're getting the best option for their specific healthcare needs.

According to a recent article in USA Today, patients should check for changes in plans, even if there haven't been changes to their health. Physicians may no longer be available under their current plan, and plan costs and reimbursements for different medications can change year to year. It's not just important for a patient to check for other policies that could be more cost-effective given their current situation -- according to The Motley Fool, the number one mistake patients can make is not reviewing their Part D plan choices.

New plan options in Part D are usually available each year, and this year boasts 2 independent pharmacy-owned options for patients in the states of Arkansas, Georgia, Illinois, Pennsylvania, and West Virginia. Indy Health's SaverRx and EliteRx plans, both of which feature independent pharmacies as preferred network providers while still offering other pharmacies as options, are cost-effective choices that put patients instead of corporate profits first. 

Patients should be encouraged to review their Medicare options and take advantage of the plan that's best for their current needs. In the battle for affordable healthcare, educated choices will be their best friend.
 
  AROUND PUTT  
  PUTT MEMBERS USING THEIR VOICE  
 



It takes a courageous voice to strike out against the PBM Goliaths, and pharmacists in the states of Minnesota, Michigan, and Arizona are doing just that!

ARIZONA
PUTT Executive Director Monique Whitney has teamed up with former PUTT President Teresa Dickinson to form the Arizona Independent Pharmacy Coalition (AZIPRx). They and a group of independent pharmacy owners from across the state are working to introduce a transaction fee reform bill similar to a bill recently passed in Texas. 

MINNESOTA
PUTT board member Deborah Keaveny got tired of getting the runaround in Minnesota, so she formed the Minnesota Indys (MNIndy). The group is now 90 members strong and acts as a support system for each other to help with everything from MAC appeals to contract scrutiny in addition to advocating for PBM reform.

PUTT MICHIGAN
The newest PUTTbull in the pound is PUTT Michigan. The chapter was spearheaded by PUTT member Nathan Mair, who got fed up when PBM reform bills passed unanimously through the MI state legislature but continued to get vetoed by the governor. We look forward to working with him and the Michigan pack!


 
  LAUGHTER IS THE BEST MEDICINE  
  THINGS THAT MAKE YOU GO "BOOOOO"  
 



 
 
  LOOKING AHEAD  
  SPOOKY THOUGHTS  
 
 
  ADDITIONAL WORTHWHILE READS & STORIES  
  ICYMI  
 

Insulin Costs Up to 10 Times More in U.S. Compared with Other Nations
October 7, 2020
Kaiser Health News

Senator Wright Receives Senate Champion of the Year Award
October 6, 2020
Orlando Political Observer

When Applying Manufacturers Coupons Could Get A Pharmacy In Trouble
September 16, 2020
The Pharmacy Insider

More Executive Orders Will Not Make Medicines Cheaper
September 10, 2020
The Hill