Florida Independent Pharmacies Take Action Against CVS-Caremark Anti Trust Practices

Independent pharmacies met to discuss the CVS merger with Caremark, the nation's largest Pharmacy Benefits Manager (PBM) and the resulting anti trust issues as they relate to the fate of the industry, their businesses, and overall patient care.

Last week 80 independent pharmacies met in Hillsborough County, Florida to discuss the effects of the 2007 CVS merger with Caremark, the nation's largest Pharmacy Benefits Manager (PBM). Pharmacists from Tampa, Orlando, and areas in between met with representatives of the Florida Independent Pharmacy Network and the PPSC to discuss anti trust concerns and the fate of the industry and their businesses as well as overall patient healthcare.

David Balto, an attorney for community pharmacists spoke to the group. Mr. Balto has represents the National Community Pharmacists Association and other pharmacists in the investigations of CVS/Caremark. These complaints have led to an investigation by the Federal Trade Commission and 24 state attorneys generals. Mr. Balto outlined the concerns raised by community pharmacists and consumers:

1) CVS has access to the most competitively sensitive information of rival pharmacies including the identity of their customers and prescribers, the drugs prescribed, the cost of the drugs, the amount of drugs acquired, the drug acquisition cost, and the reimbursement amount;
2) CVS sets the level of reimbursement for its rivals, unprecedented in any industry;
3) CVS uses its so-called "Maintenance Choice" program to drive consumers from their pharmacies to CVS stores; and
4) CVS has access to personal PBM customer information.

Balto notes that pharmacies and consumers in all 50 states have presented over 400 complaints about anti trust and anti competitive acts by CVS including the following:

1) CVS Caremark uses egregious auditing practices to gain a competitive advantage over rival pharmacies.
2) CVS Caremark forces CVS pharmacy customers enrolled in Medicare Part D to reach the coverage "doughnut hole" faster. Independent pharmacies have little to no bargaining power when negotiating their network contracts with PBMs. As a result, CVS Caremark determines reimbursement rates for pharmacy drug claims. CVS Caremark's power to set reimbursement rates harms both independent pharmacies and Medicare Part D enrollees.
3) CVS Caremark's conduct is anticompetitive and potentially violates Section 5 of the Federal Trade Commission Act and Section 7 of the Clayton Act.

Balto says, "Independent pharmacists believe that the Federal Trade Commission should seek enforcement action against CVS Caremark's anticompetitive and deceptive conduct including divestiture of Caremark."

Leke Alli of Bearss Pharmacy in Tampa says that the meeting was a call to action for independent pharmacies to urge their staff, business associates, and patients to launch a campaign to generate support from politicians and the general public. Alli says, "Aside from everything else, CVS has a mail order program that will directly cut out the other pharmacies. This will affect jobs, revenues, the local economy, and, of course, patient care. " Alli says that with mail orders, there are no patient and drug monitoring practices in place so the patient loses touch with much needed healthcare and expertise that only pharmacists can provide. He also notes that the drugs are not cheaper through mail order for the patient but the reimbursements are larger for the pharmacy distributing them.

Alli encourages other pharmacies to take action because time is of the essence. "Every day that goes by, we lose more and more money to CVS. By the time we win the cause, damage will already be done. We need to keep it to a minimum", he says.

Industry activist Pharmacist Dan Fucarino of Carrollwood Pharmacy in Tampa, Florida agrees that the CVS-Caremark practices are out of control and action to stop them is needed now. He says the meeting was a huge success and a great start to a very intense campaign against the big companies. "We were expecting a handful of pharmacists and were surprised and pleased by the turnout. Independent pharmacists work day and night and for them to come out on a Sunday afternoon for several hours shows the level of commitment to the campaign", says Fucarino.

President of the PPSC in Tallahassee, Cyndi Mincy, also attended the meeting and said that the meeting was a focused one with the group taking away several action items including petitions, town hall meetings, solicitations, and general lobbying efforts. Referring to her 28 year old group's support of the independent pharmacies' efforts she says, "Their business is our business. We support the independent pharmacies efforts to create and maintain a fair trade environment where all can compete on the basis of quality care and service for their patients for the benefit of all concerned."

Representatives Paul Franck and Jim Powers of the Florida Independent Pharmacy were also in attendance.

For more information on how you can get involved, contact Dan Fucarino at Carrollwood Pharmacy at 813-961-8798 or Leke Alli at Bearss Pharmacy at 813-341-1555.

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Tags: anti trust, Caremark, CVs, Cyndi Mincy, Dan Fucarino, Florida Independent Pharmacy, Independent Pharmacies, Independent Pharmacists, Leke Alli, Mail Order Prescriptions, medicare part d, National Community Pharmacy Asso, pharmacies, PPSC


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