2020: A YEAR TO... REMEMBER?  

While 2020 may have seemed like the worst year in modern human history, it was a busy one for PUTT and our members. With just a few days before the holidays and plenty of reasons to celebrate (Rutledge v. PCMA victory; COVID vaccines) we thought we'd take a moment to reflect on some of the many accomplishments of PUTT and PUTT members over the last 12 months:
In January and February, we launched  The PUTTcast, and began regularly guest-hosting on the PBM Reform podcast series for Pharmacy Podcast Network in an effort to further PBM reform by sharing information and resources. We connected members who'd been affected by OptumRx practices to attorney Mark Cuker, whose firm launched a lawsuit against the #3 PBM in multiple states.
The beginning of March brought the full onslaught of COVID. During the first weeks of the crisis PUTT developed and sent a Local Pharmacy Engagement 4-Point Plan to Boards of Pharmacy, Departments of Insurance, and the Governors' Coronavirus Task Forces in all 50 states. We compiled the responses and published them to the media and our website.

In April and May we conducted Medicaid managed care surveys of independent pharmacies in Florida and Illinois... Continue Reading


In a unanimous decision issued in the early morning hours of December 10th, SCOTUS delivered a blow to PCMA'S fallback argument that ERISA preempts states' rights to regulate PBM practices in self-insured plans with their decisive ruling in favor of Arkansas AG Leslie Rutledge and state's rights to regulate. In delivering the Court's official ruling, Justice Sotomayor noted that "PCMA's contention that Act 900 has an impermissible connection with an ERISA plan because its enforcement mechanisms both directly affect central matters of plan administration and interfere with nationally uniform plan administration is unconvincing."

Immediately following the verdict, AG Rutledge issued the statement, "This is an important unanimous win for not only locally owned pharmacies that have experienced financial hardships at the hands of pharmacy benefit managers, but more importantly, this is a win for all Arkansans and Americans to have access to affordable health care. I will always protect Arkansans and small businesses from unfair practices and fight to lower the costs of prescription drugs."

PUTT applauds the High Court's decision in Rutledge v PCMA. The ruling itself was broadly worded; indicating that PCMA may find it difficult to continue to initiate lawsuits based upon ERISA preemption going forward. While PCMA will likely spend the next year lobbying against reform efforts on a state by state level, their official response to the SCOTUS decision equated to "please ignore the man behind the curtain!" -- a tactic that we believe legislators will see through.

Trump's Drug Cards Clear Key Hurdle Following Pressure from White House
December 14, 2020 Politico

President Donald Trump's stalled campaign promise to send $200 drug-discount cards to seniors has new life after an obscure-but-important industry panel on Monday night gave its blessing, ending weeks of resistance to the plan.

The White House has positioned the plan as a legally authorized "test" of the Medicare program, but drug policy researchers questioned the usefulness of the effort.  Continue Reading

Cutting Out the "Middleman"? HHS Resurrects Anti-Rebate Rule for Medicare Part D
December 9, 2020 Lexology

On November 20, 2020 the Department of Health and Human Services ("HHS") and the HHS Office of Inspector General ("OIG") issued a final rule ("Final Rule") that the agencies contend will help to lower prescription drug prices by changing the structure for drug payments and pharmacy benefit manager ("PBM") services...if it survives anticipated court challenges, the Final Rule will modify the federal health care program's Anti-Kickback Statute ("AKS") safe harbors in three key ways:..  Continue Reading

U.S. Healthcare Markets Lack Transparency; Stakeholders Want To Keep It That Way
December 7, 2020  Forbes

The U.S. healthcare market, and pharmaceuticals in particular, does not work the way economists envision markets are supposed to. Asymmetries of information are omnipresent.. (and) because most of the costs of treatments are paid for by third parties, patients and healthcare providers are unaware of their true costs.

The pricing of healthcare services and technologies that emerges from the maze of intermediaries and contracts, across a wide array of stakeholders, is arcane and inscrutable... Continue Reading

State Suit Against Drug Middlemen Delayed
December 6, 2020  Patch

Ohio's first lawsuit against middlemen accused of overcharging state agencies for prescription drugs has again been delayed.

In it, the state says Optum overcharged the agency between 2015 and 2019 by $16 million - a relatively paltry sum by prescription drug standards. But it could have much larger implications for taxpayers and for the middlemen, known as pharmacy benefit managers.  Continue Reading

Patient and Provider Groups Call on Congress to Stop CMS Policy
December 1, 2020 Policy & Medicine

Recently, the All Copays Count Coalition (ACCC) sent a letter to House of Representatives Speaker Nancy Pelosi and Minority Leader Kevin McCarthy, asking them to support H.R. 7647, the Preserving Patient Savings on Drug Costs Act.

H.R. 7647 is a bipartisan bill introduced in the United States House of Representatives that would temporarily delay implementation of the "copay accumulator adjustment program"... a policy adopted by health insurers and pharmacy benefit managers (PBMs) that prevents copay assistance from manufacturers from being applied toward a patient's annual deductible or out-of-pocket cost limit.  Continue Reading


North Carolina
Pharmacist Seeks Protections for Small Pharmacies

December 5, 2020  The Daily Advance

An Edenton pharmacist and business owner is calling on state legislators to take steps to protect small, independent pharmacies. Jim Blount, owner of Blount's Mututal Drugs in Edenton, said recently he hoped the N.C. General Assembly would enact the proposed NC Pharmacy Benefits Manager Licensure Act... state Sen. Bob Steinburg, R-Chowan, said Blount's concerns are valid and that he's open to introducing a version of the act or similar legislation to address those concerns.  Continue Reading
*Don't Miss NCAP CEO Penny Shelton's OpEd in the Fayetteville Observer below in ICYMI

Medication Pricing Transparency Bill Signed Into Law
December 4, 2020

Bipartisan legislation aimed at increasing transparency to pricing practices of pharmacy benefits managers was signed into law by Wolf, its sponsors said in a statement Dec. 1. State Rep. Doyle Heffley, said the measure would reduce costs to Pennsylvania's Medicaid program. State Rep. Rob Matzie, was the key Democratic co-sponsor of the bill.

"We have been working on this legislation for more than three years and during that time have continued to hear from our local pharmacies about severe cuts to pharmacy reimbursement rates by PBMs...  Continue Reading

Civil Rights Groups Escalate Fight Against High Prescription Drug Costs
December 1, 2020 The Times Weekly

Civil rights leaders across the nation are now pressing increasingly hard to establish public policies to monitor and help make prescription drug prices affordable. Best known for their efforts to address police misconduct, voting rights protections, racial inequality, and economic injustices, civil rights organizations are now escalating their focus on issues in the area of healthcare - particularly the high cost of prescription drugs.

"While there has been much partisan back and forth on these issues in Washington, there has not been enough conversation about reining in the profits and excesses of health insurance companies, which refuse to cover critical procedures, medicines, and services in order to preserve their billions of dollars in profits," said the Rev. Al Sharpton... Continue Reading


A Message from PUTT President, Scott Newman

The recent emergency approvals of our first COVID vaccines are a light at the end of the pandemic's very dark tunnel, but for many local pharmacies, the rollout is yet another nose-thumb in the face of countless transgressions that PBMs have heaped upon our already exhausted industry. It was only after arranging secretive deals to be named the sole phase one vaccination providers, CVS realized the true logistics -- their chain pharmacies are not everywhere. 

Independent pharmacies have been the service providers for large and local nursing home facilities for decades. To now have CVS push their way in to execute a patient take-over sanctioned by the federal government is an insult to our profession and our communities.

The irony here is that these same corporations raking in record profits during the COVID crisis have cut staff and hours to the point that they cannot fulfill the requirements of the job our government contracted them to do.

CVS's response? Ask the local independent pharmacies -- who they have consistently strived to drive out of business -- to volunteer to assist.

Independent pharmacies are known for going above and beyond to care for their patients, but preying upon that instinct in yet another effort to pad their own bottom line is inexcusable. 

Shame on them! The COVID vaccine rollout should be about ensuring we put an end to this life-threatening pandemic once and for all -- not secret deals, corporate greed, and shareholder dividends.

CMS, let this be a lesson; community pharmacies are and should be viewed as frontline soldiers -- not an afterthought to a corporate-run system that already cheats the U.S. healthcare system out of billions of dollars each year.

- Scott Newman, PharmD

CVS, Walgreens Seek Pharmacists on the Eve of Vaccination Rush
December 8, 2020  Bloomberg

CVS Health Corp. and Walgreens Boots Alliance Inc. are aggressively recruiting pharmacists, pharmacy technicians and nurses to administer Covid-19 vaccines in long-term care facilities, just days before the drugstore giants are expected to play a key role in a large immunization effort.

Representatives from the two companies are making in-person and virtual pitches to independent pharmacists, according to National Community Pharmacists Association Chief Executive Officer Douglas Hoey. Continue Reading

The Health 202: States are Receiving Vaccines Based on the Size -- Not the Risk -- of Their Populations
December 9, 2020  The Washington Post

All states are not equal when it comes to the vulnerability of their citizens to the novel coronavirus. Some have more elderly or low-income people. Others have disproportionate shares of those with underlying medical conditions.

Yet states will all be allotted coronavirus vaccines based on a simple metric: How many adults reside within their borders.

And states can send their allotted vaccines wherever they want. 
Continue Reading

As the saying goes, "Get into politics or get out of pharmacy!"
Click Here to download FiscalNote's 2021 State by State Legislative Calendar and stay informed on important session dates and deadlines in your state!

Did You Know... 

Your PUTT membership is a tax-deductible donation

As 2020 draws to a close, healthcare issues and questions that affect the business of independent pharmacy continue to emerge. PUTT fights every day, not just for the rights of independent pharmacies and their patients, but to ensure our members have access to timely, important information and tools they can use to end PBM and other systemic abuses.

PUTT members aren't in it for the glory. PUTT members are a self-selected force of nature: speaking truth to power; sharing evidence; taking back our industry and empowering others in pharmacy to do the same.  See how your membership contributions are making a difference in pharmacy every day.

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Drug Middlemen Shift Arguments to Escape Liability, State Laws
December 9, 2020 
Bloomberg Law

NC Residents Should Pick Their Pharmacist, Not Be 'Steered' Elsewhere
December 5, 2020 
The Fayetteville Observer

Amazon Pharmacy Boasts Big Discounts for Prescription Meds, but Probably Isn't the Best Deal
December 4, 2020

Trump Administration's Eleventh-Hour Drug Pricing Regulations Face an Uncertain Path Forward
December 4, 2020
JD Supra

Three Guiding Principles for Patient-Centered Decision-Making in Washington for 2021
December 2, 2020
On Town Media