MOUNT IDA – Pharmaceuticals were the topic last week during a round table discussion hosted by Arkansas Attorney General Leslie Rutledge at the Civic Center in Mount Ida.
Attorney General Rutledge spoke with area officials, business owners and law enforcement agencies for about an hour with the discussion of the alleged abuse of position by pharmacy benefit managers (PBM).
The AG opened the meeting with a brief introduction, welcoming everyone to the meeting before opening the floor for discussion.
Prosecuting Attorney Andy Riner brought up a lawsuit that has been filed by several local and state agencies and municipalities which alleges pharmaceutical companies were aware of the possible danger of addiction in several opiates being prescribed.
It was also mentioned that the combination of a rise in prescription drug use and the rising costs of such drugs has caused a rise in the use of heroin and fentanyl as people try to satisfy their addiction.
Pharmacist Bryna Criswell stated that pharmacies are seeing a younger demographic using prescription opiates which adds to the problem. She added that part of the answer can be found in the proper prescription of opiates and drug take back programs. Sheriff David White stated that Montgomery County has a drug drop box at their office in the courthouse.
Attorney General Rutledge remarked that although the drug drop boxes were a good program they are often only used for drugs no one wants. She went on to say that many people clear out family members’ prescriptions after they die and keep the drugs they want while throwing away the rest. Sheriff White added that much of what they get in their drop box is vitamins.
Sheriff White brought up theft of mail order prescription drugs. He stated that the VA will mail up to three months of a prescription to residents which are then stolen from their mailboxes and homes.
Attorney General Rutledge stated that education was important to addressing the problem. She mentioned that the state has a program entitled “Prescriptions for Life” which helps teach school age children the dangers of prescription drub abuse. This is the first program of its kind in the nation.
She stated that the program was created to help combat the rise of drug use in school age children. She added that Arkansas is number one in the nation for drug use among children ages 12-17.
Discussion on this topic wrapped up with Prosecuting Attorney Riner thanking Attorney General Rutledge for looking into the problem.
Criswell brought up the topic of drug reimbursement in the state and the affects it is having on locally owned and operated pharmacies.
She began by reminding everyone about the benefits of having a local pharmacy in a rural area. These benefits go beyond access to medication and include sponsorships of local sports teams and support of local charities and schools.
Criswell went on to allege that CVS/Caremark, Arkansas’ pharmacy benefit manager, was misusing it’s position to benefit it’s own pharmacy franchise. She explained that as a PBM they are able to negotiate different reimbursement amounts for pharmacies with insurance companies, including Medicare and Medicaid. She alleges that as a result the local pharmacies are being reimbursed less than CVS pharmacies which are owned by the state’s PBM.
Attorney General Rutledge confirmed that PBMs work to set contract prices between pharmacies and insurance agencies. She stated that there are multiple allegations in Arkansas and across the country that PBMs, including CVS/Caremark, have contracted reimbursement payments for some pharmacies that are drastically under cost for pharmaceuticals.
Currently the Attorney General’s office is investigating reimbursements being offered to different pharmacies and the rates that have been negotiated by CVS/Caremark. There are also allegations that CVS is now reaching out to struggling local pharmacies with buyout offers.
“This is alarming” Attorney General Rutledge stated.
There have been some adjustments in reimbursements in recent weeks, but Criswell stated that local pharmacies are still struggling. She pointed out that if local pharmacies close it is the rural residents who suffer because they will have to drive further to get prescriptions filled.
Criswell stated that there is no oversight for PBMs on the federal or state level. She and other pharmacies are asking the state to pass legislation that would put them under some sort of state oversight through the insurance commission. She added that such legislation is expected to be part of an upcoming special session in the state legislature.
Criswell also alleged that CVS’s mail order company was calling prescription holders just before their prescription runs out offering refills through the mail, thus robbing local pharmacies of a customer.
She alleged that the PBM is taking copies of prescriptions submitted by pharmacies and sharing it with the pharmacy companies they own. She explained that when Caremark was allowed to purchase CVS Pharmacy that they were required to create a separation of information between the two companies. However, she alleges that they are ignoring “firewalls” put in place to prevent these types of abuses.
Attorney General Rutledge was very interested in this allegation, stating that she was not aware of this problem and would dig deeper into the claim.