Thursday, August 28, 2014

More Breaking News: Triad Rx Inc Suing Express Scripts over terminating Pharmacy Provider Agreement

view complaint here.   A copy of the Request for Temporary Restraining Order and Memorandum in Support can be found in PACER filed in the Eastern District of Missouri. The court has not set a hearing yet.

Specialty Pharmacy and Distribution Networks

Specialty Pharmacy and Distribution Networks

McKesson, Rite Aid, and the Changing Generic Channel (rerun)

McKesson, Rite Aid, and the Changing Generic Channel (rerun)

Seven Trends For Specialty Pharmacy’s Future: Reflections on Armada 2014 (rerun)

Seven Trends For Specialty Pharmacy’s Future: Reflections on Armada 2014 (rerun)

Which PBM Best Manages Drug Trend? Express Scripts vs. Caremark vs. Catamaran vs. Prime (rerun)

Which PBM Best Manages Drug Trend? Express Scripts vs. Caremark vs. Catamaran vs. Prime (rerun)

Indiana Hires Second Lab to Handle Backlog

Indiana Hires Second Lab to Handle Backlog

Ontario Drug Benefit Formulary Edition 42

Breaking News: Concierge Compounding Pharmaceuticals Inc. v. Express Scripts Inc.: A Lawsuit seeking to Stop Express Script from Terminating a Compounding Pharmacy from its Network-hearing set for tomorrow August 29, 2014


On August 25, 2014 Concierge Compounding Pharmaceuticals, Inc. (Concierge) filed a motion for temporary restraining order, a memorandum in support, and a complaint for injunctive relief against Express Scripts.  In the complaint Concierge, states that it specializes in compounded prescription medications and is "a fully licensed, single-location retail pharmacy, that has approximately 50 employees, It is licensed in 40 states and fills approximately 6,900 prescriptions per month to patients nationwide."  Concierge also states that is contracts with a PSAO, AmerisourceBergen drug Corporation d/b/a Good Neighbor Pharmacy Provider Network in order to do business with Express Scripts and other PBMS.  It claims 80 to 85 percent of its customers are members of health plans whose prescription drug benefits are managed by Express Scripts.  Concierge apparently received a termination letter from Express Scripts indicating it had incorrectly answered a question "no."  The question asked whether Concierge had ever waived or offered a reduction of member co-pay.  Concierge indicates it has a policy against this except in the case of hardship,  and that this hardship policy doesn't make its answer on the question untrue.  The court has set a hearing on the motion for tomorrow August 29, 2014.

View Motion
View Memo of Law in Support of Motion
View Complaint for Injunctive Relief













 




 

Enforcement Reports August 20, 2014

Enforcement Reports August 20, 2014

Great Read: One Doctor's Answer to Office Use Compounded Medications--Questions to Consider

08/28/2014    Allen Jacobs, DPM

In-Office Compounding


In-office compounding has been around a long time.
There is nothing wrong with compounding selected
pharmaceutical ingredients in your office for
patient treatment. The issue your question raises
is not about Stark Law. It should be about medical
liability, kick-back laws, ethics, and not
jeopardizing your in-network medical status with
payers.

1. Liability is a major issue. When a pharmacist
dispenses a drug to a patient, they hold 100% all
patient liability for safety around allergies,
drug to drug interactions, contraindications and
side effect profile. The pain creams sound pretty
simple but most of them have 5-8 active
ingredients (including CII and CIII drugs) and the
bases contain over 25-30 ingredients.

Although the systemic exposure is less than oral,
there is still exposure and it varies depending on
skin type (elderly and children). When there is an
issue with the medication you dispensed, you are
the one the patient calls for immediate solution.
Due to this, you will also need to have a 24 hour
hot line to field non-911 issues. The companies
that are doing this shell game are passing all
liability on to you so be sure to increase your
liability coverage with the money you gained from
playing pharmacist. This is not worth my time.

2. Price gouging: The company is charging
insurance companies ridiculous amounts of money
and passing a fraction of that revenue to you.
Just remember that when a patient’s insurance gets
billed thousands for the pain cream, you will be
the one the patient comes running to. It usually
presents itself as a patient carrying an EOB
yelling, “you charged my insurance $3,500 for that
cream.”