Saturday, June 01, 2013

Because It's CVS

(Editorial cartoon by Mike Luckovich and published 5/16/13 in the Atlanta Journal Constitution.  Click on image to enlarge and then return.)

David Lazarus reminds us again why we can't have nice things.  And, sadly, once again CVS Caremark is involved.

Consumers have been told by insurers again and again that if they want cheaper prices for prescription drugs, they need to order them in bulk from mail-order pharmacies. And typically, it works out that way.

Sometimes, however, the prices reveal how screwy our healthcare system is — and what a challenge it can be to get a straight answer about medical costs.

Jeff Zoldos, 61, had such an experience after his employer switched his coverage to Aetna at the beginning of the year.

The Tustin resident went to Aetna's website to check his options for filling a prescription for the generic version of the cholesterol drug Lipitor. It said he could go to a retail drugstore such as CVS and buy a 30-day supply for $37.62.

Or he could order a 90-day supply from Aetna's own mail-order pharmacy for $400.86.

Huh? The mail-order option was nearly four times as expensive as the retail alternative.

Making things even stranger, Aetna outsources its drug transactions to CVS Caremark, which means CVS is the one negotiating prices with pharmacies on Aetna's behalf. ...

The episode highlights how difficult it can be for consumers to know whether they're being charged a fair or even reasonable price for prescription drugs. It also shows that if you take the initiative, as Zoldos did, in trying to get answers, you can quickly find yourself being stonewalled.   [Emphasis added]

Medical costs will not go down until insurance companies and their coordinating agencies, like CVS, decide to give their insureds what they paid for, which means never if regulating agencies at the state and federal levels don't step in.

ACA will help somewhat as more of it becomes active, as will CMS on the Medicare/Medicaid front, but until we yank these for-profit private entities out of the equation, this kind of insane imbalance will continue.

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