I get all my prescriptions at Walgreens. When late last year they started slipping in with my meds these little notices urging me to call Anthem Blue Cross because of some pricing dispute, along with sending me warning letters that I’d better switch all my prescriptions to a non-Walgreens because Anthem’s Rx contracter was severing its relationship with them, I told my wife, and I quote:
“Never gonna happen. Just posturing during the negotations.”
And thus ended my career as a pharmaceutical-sector financial analyst. KQED’s Sarah Varney explains on our State of Health blog….
As of January 1, Californians who go to Walgreens to get their prescriptions filled may have been in for a surprise. Because of a contract dispute between Walgreens, the nation’s largest drugstore chain, and the company that manages prescriptions for Anthem Blue Cross health insurance, many customers will have to find a new pharmacy.
To find out if you’re affected by the dispute, you should check the back of your insurance card. If it says “Express Scripts,” you can no longer fill your prescription at Walgreens under your insurance plan. Express Scripts is a pharmacy benefit manager or PBM. PBMs negotiate prices for drugs and oversee prescription drug programs for health insurance companies, governments, unions and others…
Health care experts are somewhat befuddled by the stand-off. Sean Brandle is a pharmacy benefit expert at the Segal Company, a New York-based employer benefits firm. He says tussles between pharmacy chains and PBMs are pretty typical. But he also said he’s surprised Walgreens would walk away from so many pharmacy customers and all that in-store foot traffic. Express Scripts says of the 750 million prescriptions it processed last year, about 90 million were filled at Walgreens.
Caught in the middle of the dispute is one of California’s biggest health insurance companies, Anthem Blue Cross, and its millions of customers like San Francisco resident David Forer. There’s a Walgreens just down the street from his downtown San Francisco office, and he used to stop in weekly to pick up insulin for his daughter who has Type 1 diabetes. “They knew me on a first-name basis,” Forer said. “They wouldn’t even ask me my name when I came up. I would just go and get the prescriptions. They would ask how she was doing, and now I can’t go there anymore.”