Sunday, June 21, 2009 — While President Barack Obama and the Congress are tackling the enormity of America’s healthcare system, one basic, key element of that system — the dispensing of doctor-prescribed medications — has become a nightmarish situation for many patients, especially seniors, since a merger of two giants of the industry, so say the National Community Pharmacists Association (NCPA).

Since the merger in March 2007 of CVS Pharmacy and Caremark, the NCPA insists the merger has created “a virtual monopoly limiting consumer options.”

According to the NCPA, this combination of CVS (the nation’s largest retail pharmacy with more than 6,800 pharmacies) and Caremark (the nation’s largest pharmacy benefits manager) affects 134 million consumers and fills or manages 1.2 billion prescriptions annually, thus controlling or influencing the prescription benefit of an estimated one of three Americans.

Back on May 13, the NCPA took their fight against the merger before the Federal Trade Commission (FTC).

“Community pharmacists have received many complaints from patients and pharmacists about CVS Caremark’s higher prices and questionable marketing practices,” said Holly Whitcomb of the NCPA President and a Seattle, Wash. pharmacy owner.

Whitcomb stated that since the merger, the NCPA has been bombarded by complaints from patients due to higher prices and questionable marketing practices by CVS and Caremark.

In addition to Whitcomb, community pharmacists and patients alike shared their horror stories, such as the Wisconsin pharmacist whose patient tried to fill a prescription to coincide with her chemotherapy.

“Her plan does cover the medication, but when we attempted to fill it, she was told it had to come from their CVS Caremark mail-order service. This delay will affect her chemo cycles and possibly her whole recovery,” the pharmacist said.

One North Carolina patient on Medicare Part D operated by CVS Caremark switched his and his wife’s prescriptions to CVS in March 2009, expecting lower prices as advertised. Instead, he received an extra $12 co-pay while CVS was reimbursed $302 more than had been the previous pharmacy. In total, the plan paid $11.08 for seven drugs to the prior pharmacy and $313.17 to CVS, a 2,800 percent increase of government payments.

As local pharmacist Wayne Sasser (Medical Pharmacy of Albemarle and Medical Pharmacy of Locust) explains, these situations are particularly tough on seniors.

“Medicare Part D customers basically have $2,700 worth of drug coverage in a government account that they draw from,” Sasser said.

“When large drug chains negotiate higher reimbursements from drug companies and get more insurance money back from insurance companies for the same drugs, a patient uses up the $2,700 much faster.”

And once that threshold is met, the patient then pays 100 percent of the charges for future prescriptions.

Another local pharmacist, Stan Leggett of Albemarle Compounding and Prescription Center, sees what’s happening today as “criminal, intentional and medical fraud.”

“There’s no place in healthcare for this. As a pharmacist, I represent the patient, the pharmacy and the taxpayer and this is just one more thing we face on a daily basis. It’s very frustrating for me personally because the people trust me to treat them right,” said Leggett, now in his 29th year as a pharmacist.

“This constant fighting with the insurance companies is not what pharmacy used to be. It used to be built on trust, integrity and treating people right. Today’s it’s all about greed.

“The taxpayers aren’t being treated fairly either for Medicare is a taxpayer funded program intended to help seniors.”

When asked for his position on the matter, Congressman Larry Kissell, who has previously visited Leggett and other local pharmacists to better understand the dilemma, issued the following statement:

“I am deeply concerned about the CVS Caremark situation. It isn’t good for our seniors or our local pharmacies and certainly isn’t good for our government. I have been working with other members of Congress to try and find a solution for this on-going situation which has been ignored too long. We simply cannot allow companies to manipulate the Medicare system.”

In response to the SNAP’s query, Christine Cramer of CVS Caremark responded: “CVS Caremark disagrees with NCPA’s mis-characterization of our business practices. The merger of CVS and Caremark is, in fact, making pharmacy health care more accessible, more effective and more affordable. Our integrated pharmacy and PBM (Pharmacy Benefits Manager) operations provide greater choice and more convenience for patients, improve health outcomes, and lower overall health care costs for plan sponsors and participants.”