Category Archives: Pharmacies

Follow-up to CVS to Buy Aetna

As I reported last month, and in today’s New York Times and Wall Street Journal, CVS has agreed to buy Aetna for $69 billion, reshaping the US health care industry, according to the Times article.

The transaction, the article said, is one of the largest of the year, and would combine the drugstore giant with one of the biggest health insurers in the US. It would blur the lines between traditionally separate spheres of the health care industry.

This move by CVS is response to moves by Amazon, which has quietly laid the groundwork for an entry into the United States’ pharmacy business.

According to the Wall Street Journal article, Aetna stockholders will receive $207 a share, $145 in cash and 0.8378 of a CVS share, or $62 in stock.

 

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CVS to Buy Aetna

This should wake you up before your morning coffee.

Reuters is reporting that pharmacy operator, CVS Health Corp. is making a bid for Aetna Insurance.

Bid is more than $66 Billion.

Here is the article from Reuters.

Do we really think a pharmacy should own an insurer? What ever happened to the idea of competition is good?

One day, we will live in a world like that of the movie, Rollerball (the one with James Caan), where corporations run the world, and your wife can be taken anytime by a corporate executive.

Medical Management Internship Paper, Summer 2011

No doubt, many of my readers have wondered what I learned in my MHA degree program, and why my writing has been of interest to so many of you.

Upon checking my stats for the blog, I noticed that someone had viewed a paper I wrote in the summer of 2011 for my Summer Internship course, as part of my MHA degree program requirements. The school I attended required all students without a health care background to take a one-credit course as an Intern in a health care organization.

The organization I choose was one my school already contracted with, Broadspire. At the end of the course, we were expected to write a paper about our internship for a grade in the course.

The following link will direct the reader to a copy of my paper that I hope the reader will find interesting, and will highlight my skills as a researcher and writer. Speaking engagements as well as research opportunities are most welcome, as are full-time positions and consulting opportunities.

https://www.dropbox.com/s/5573hm8xo074po0/Medical%20Management%20Internship%20Paper.docx?dl=0

As the summer session was very short, only three projects were undertaken, and the last one was truncated due to time constraints and the report presented to Broadspire concentrated on only two states, Florida and California.

Let me know your thoughts.

Drug Costs Make Up Bulk of Work Comp Medical Costs [Infographic]

As reported today on PropertyCasualty360, medical services now contribute to more than 60% of Workers’ Comp claims, in part due to two cost drivers: physician dispensing and compounded drugs, according to Marsh.

While the industry continues to grapple with the cost drivers of physician dispensing and compounded drugs, it would be prudent also to tackle the rest of the medical services that are contributing to more than 60% of claims under workers’ comp.

Expensive surgeries are also another factor in this that no one is discussing, no one at least inside the industry itself. No wonder that medical services have reached that high a percentage.

Oh well, you can lead dumb horses to water, but you can’t make them drink, so let them keep doing the same things over and over again and hope to get different results.

Here is the infographic:

War on Drugs

Compounding and Medical Tourism: What to watch out for.

Image

After a short hiatus, I am back to writing, and today’s post concerns another issue that is plaguing the workers’ compensation industry in the US, the compounding of drugs.

Joe Paduda, whom I have mentioned before, wrote today about the problem in his Managed Care Matters blog. The article, entitled, Just how dangerous Is compounding?, says that compounding is much more dangerous than compounding pharmacies and their supporters have led the workers’ compensation and health care industries to believe.

He cites a Washington Post investigation that reported that  shoddy practices and unsanitary conditions at three pharmacies have sickened and killed patients.

Paduda also stated that compounding is a growing phenomenon, especially in workers’ comp, and pointed to research from the California Workers’ Compensation Institute (CWCI) and CID Review indicate that despite the lack of any evidence-based research justifying widespread use, compound meds are becoming a larger part of pharmacy spending

What has happened in California, Paduda says, can be used to forecast the future for compounding in other states.

He states that California recently tried to address the issue legislation which specifically focused on the ingredient cost. The result of that legislation was, the number of scripts dropped 35% (from 3.1% of all scripts to 2%)…however the cost per script zoomed.  Compounds now account for one out of every eight dollars spent on drugs…

(see CWCI’s February 2013 report for details on what happened and why)

Joe also cites David DePaolo’s blog that reported on a criminal case involving payments to physicians for prescribing compounds;

“The complaint, filed by the owners of a medical billing company in the U.S. District Court in New Hampshire, alleges that Cyrus Sorat is a part owner of Health Care Pharmacy and Deutsche Medical Services in Tustin, Calif., and paid 208 doctors to prescribe compound drugs to injured workers needing topical analgesics. Sorat promised to pay the doctors an unreported fee for each prescription they wrote, and also agreed to handle billing and recover receivables on behalf of the physicians, according to the complaint.”

Just like the prescribing of opioid medications, the compounding of drugs is a serious issue that medical tourism industry personnel need to be aware of, especially if they are going to pursue patients injured on the job from the U.S.

One needs to have their eyes open to the possibility that drugs prescribed for patients by doctors will be compounded by pharmacies, and that those drugs have been the cause of injury and death to patients.

As Joe rightly points out in his blog, there are scoundrels and charlatans around, and especially in workers’ comp, their last refuge.