Concerned PharmD 🇺🇸
@ConcernedPharmD
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Pharmacist. Advocate. PBMs (middlemen) profit while people ration meds. If you’ve overpaid or been under-reimbursed, you’re not alone— and I’m fighting for you.
Joined June 2024
A PBM-free or transparent fixed-fee healthcare model in the U.S. would conservatively save $90–130 billion per year—representing 14–20% of total prescription drug spending. These savings come not from rationing care or suppressing innovation, but from eliminating opaque.
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RT @kpharmd12: Two different patients, two vastly different outcomes: . Patient #1 presents prescription for oxycodone/acetaminophen 5/325m….
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RT @Saltvilledrug: Why does CVSCaremark still get to participate in Medicare? My Pharmacy would be banned. And CVS audits me.@RepMGriffith….
nypost.com
Caremark was accused of manipulating how drug costs were reported over a decade ago.
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RT @mcuban: What's never discussed is the impact the big 3 drug wholesalers and PBMs have on pricing, More distortion. In a real market ,….
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PBMs aren’t only middlemen. They also dictate your care. Forcing stable patients off stable therapy for higher rebate capture isn’t cost control. It’s profiteering based off disease states. @RepBuddyCarter @SenSanders @BillCassidy @SenatorDurbin @AmerMedicalAssn @FTC @POTUS.
@HannahR90 @HarariAvia @ConcernedPharmD @KenPaxtonTX @HealthcareGreed If PBMs were only tied to pricing, a solution could happen. But when PBMs are allowed to force stable pts off stable meds b/c another drug co paid more $$ to be on formulary, it's a real problem. Now you're playing doctor. Non-medically switched 8x. Pls ask me abt my journey.
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Cutting out middlemen (PBM’s) does lower costs. The “coverage” people think they’re getting is mostly a shell game built to funnel profit, not savings. @FTC @JusticeATR.
If pharma companies just cut out all those annoying middlemen and sold medicines directly to consumers, wouldn't that cut the prices that people pay?. Yes, but. not so much, @elaineywchen finds. Because most consumers' drug costs are mostly covered by insurance, and they don't.
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RT @mcuban: The real health insurance scam is that they know as their deductibles go up, fewer people can afford to use their insurance. W….
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Without PBM’s we would have cheaper meds. No ifs, ands, or buts.
@HarariAvia @ConcernedPharmD @KenPaxtonTX @HealthcareGreed Exactly this. People love to dunk on CVS or PBMs without realizing the alternative is letting Big Pharma set prices unchecked.
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RT @HealthcareGreed: 🚨📢😡UHG’s acquisitions are a gut punch to independent healthcare providers and patients. On August 7, 2025, the DOJ app….
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They’re not protecting access. They’re not negotiating your costs. They’re not maintaining supply chains. They’re not providing competition. They’re extracting margin at every level of the healthcare stack, while independents die and patients pay more. They don’t care how much.
@ConcernedPharmD @KenPaxtonTX @HealthcareGreed CVS, UHC, and Optum aren’t killing access. They’re the reason millions still have it. Without them negotiating costs, maintaining supply chains, and offering nationwide coverage, patients in many communities would have no pharmacy, no clinic, and no access to care at all.
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Google is free. You should do some research on your own field and contracts. Yikes.
google.com
Express scripts does not lock you into cencora,.Caremark does not lock you into McKesson for brands and cardinal for generics .Optum does not lock you into McKesson. A PBM doesn’t own these and doesn’t mandate your acquisition come from a certain wholesaler. Happy 2 educate u.
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For those curious:. • Generic Compliance Ratio (GCR) in PBM contracts is framed as a “quality” measure to ensure generics are dispensed when available (sounds good). • In practice, PBMs weaponize GCR — docking performance scores, escalating DIR fees, or even threatening.
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RT @mass_marion: Those subsidies are flowing to the BIG “insurance” companies….the corporations that Americans 🇺🇸 are so frustrated with ge….
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RT @ConcernedPharmD: @DrOzCMS Each link in the chain doesn’t just profit independently — their incentives stack. •Step 1: Manufacturer set….
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“Earlier this year, The Wall Street Journal said federal officials had launched a civil fraud investigation into how the company records diagnoses that lead to extra payments for its Medicare Advantage, or MA, plans”.
cbsnews.com
The health-care giant said it has started complying with both criminal and civil requests from federal investigators and it was cooperating with them.
We are proud to join other organizations across the health care system in pledging our support of the Centers for Medicare & Medicaid Services Health Tech Ecosystem initiative:
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True or false? . UnitedHealth Group and its many entities siphon billions from the sick and taxpayers through shady practices and backdoor deals, while conveniently forgetting to mention their role in the skyrocketing health care costs they're now trying to explain away.
True or false? See below to find out and click here for answers to other common health insurance questions:
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In 2023–24 alone, your PAC took money from Amgen, Bristol‑Myers Squibb, Novo Nordisk, Cencora, Baxter, and more. So quiet on independent pharmacies? . That silence speaks volumes.
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Senator, small business pharmacies are competition. They:.• Keep prices in check with transparent cash options.• Serve rural areas chains ignore.• Offer services big chains won’t.• Break up PBM/insurer/pharmacy monopolies. Letting them die = handing the market to 3.
Trump’s chaos is crushing small businesses. Trump’s tariffs are forcing one New Yorker to close her business. It’s a travesty.
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RT @ATAPAdvocates: ". PBMs already create barriers by dictating ultra-low reimbursement rates to local independent pharmacies, preventing….
nola.com
As a cancer patient covered by my husband’s TRICARE health insurance, I read Rob Maness’ July 11 guest column opposing pharmacy benefit manager reform with disappointment. His argument misses the
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I get why it can feel like streamlining—when the PBM, insurer, and pharmacy are the same entity, prior auths can move faster, claims can process quicker, and there’s less visible back-and-forth. The concern is that the same system deciding coverage, cost, and pharmacy access is.
@ConcernedPharmD As someone in the field, I see it more as streamlining care than monopolizing it. Patients get their medication faster, and we spend less time on red tape. How exactly would breaking up this system make things easier and more affordable for the patients?.
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