Pharmacist: CVS dominates cancer-drug business
Josh Cox says that CVS will go pretty far in trying to wrest the lucrative business of filling cancerdrug prescriptions away from oncology clinics.
The company, which operates a retail pharmacy chain and manages prescriptiondrug payments for millions of Americans, has long sent unsolicited faxes to cancer doctors, using confidential patient information, in an attempt to steer business to its own pharmacies, said Cox, pharmacy director for the Dayton Physicians Network.
CVS says that it does not engage in deceptive practices.
But two weeks ago, Cox said, the company took things to a whole new level when a representative called and told Cox that he would be breaking the law if he didn’t transfer a particular patient’s prescription to CVS’s mail-order pharmacy. Cox said that claim was false.
He would know. In addition to being pharmacy operations director for a large oncology practice, Cox sits on the Ohio State Board of Pharmacy.
“I was told it was against the law for our pharmacy to fill the prescription, which was very disturbing to me, because not only is that certainly untrue — there are no federal or state or local laws that dictate where a patient can get their prescription — but it took the whole trolling of prescriptions to a whole new level,” Cox said.
CVS has been accused by some pharmacists and lawmakers of using its dominance as Ohio Medicaid’s leading pharmacy-benefit manger to cut reimbursements to competing retail pharmacies and send letters offering to buy them out.
Pharmacy benefit managers are hired by insurers or employers to negotiate prices and rebates with drugmakers, decide which medications are covered, and set rates paid to pharmacies.
Ohio pharmacists also say that CVS uses its access to Medicare patients’ information to steer them to its own mail-order and retail pharmacies. Now, it and the other dominant PBMs also are being accused by patients and hospital administrators of forcing cancer patients into the PBM’s own mail-order pharmacies, leading to confusion and delays in getting expensive, life-saving drugs, critics say.
On Friday, CVS defended its outreach and its other business practices.
“It is not our policy or practice to mislead or intimidate patients or providers,” spokesman Mike DeAngelis said in an email. “It is common for CVS Caremark to fax prior authorizations and refill requests to providers. A patient’s specialty prescriptions may be moved to CVS Specialty if a client has switched to a preferred or exclusive network when making a change to their plan design. Patients are notified in advance if their plan sponsor chooses to make such a change.”
Cox found the company’s behavior to be unacceptable.
“It was deeply disappointing to me that the process of trying to acquire business, so to speak, had devolved into intimidation tactics among pharmacies,” Cox said.