-
How the prescription drug supply chain is killing local pharmacies
The supply chain that brings pharmaceutical drugs from the factory to the pharmacy is long, complex and unclear. Congress and several state legislatures have proposed or enacted laws to bring more transparency and curb soaring drug prices. As special correspondent Fred de Sam Lazaro reports, many small or independent pharmacies complain the system also hurts them.
Stream your PBS favorites with the PBS app: https://to.pbs.org/2Jb8twG
Find more from PBS NewsHour at https://www.pbs.org/newshour
Subscribe to our YouTube channel: https://bit.ly/2HfsCD6
Follow us:
Facebook: http://www.pbs.org/newshour
Twitter: http://www.twitter.com/newshour
Instagram: http://www.instagram.com/newshour
Subscribe:
PBS NewsHour podcasts: https://www.pbs.org/newshour/podcasts
Newsletters: https://www.pbs.org/ne...
published: 28 Jul 2023
-
Cost of prescription drugs: Mayo Clinic Radio
Dr. Vincent Rajkumar is an internationally recognized researcher and has recently been diving into this important subject. He has published articles examining the origins of today’s drug pricing challenges and while these views represent his own perspective, Mayo Clinic is privileged to speak with him to discuss the complex considerations involved in this issue.
This interview originally aired on Mayo Clinic Radio May 11, 2019.
To listen to Dr. Rajkumar's Grand Rounds talk, visit: https://youtu.be/Rb9y6bBaEzo
published: 11 May 2019
-
The Prescription Profit Chain | Professor Speaks | Pro Pharma
Professor Speaks: Episode 41 -The Prescription Profit Chain
Topics Discussed Today:
1. The Prescription Profit Chain
Make sure to click "Subscribe" to receive notification of future videos.
Don't forget to submit your questions, which we will answer on our next video!
For the Latest News Visit: http://propharmaconsultants.com/rxinfox.html
Make sure you follow our company page on Facebook for the latest updates. https://www.facebook.com/propharmainc
Additional Resources:
Thank you for joining us!
See you next week!
published: 23 Aug 2017
-
Prescription for profit: Hits and misses as state tries to crack down on Medicaid fraud
Some doctors who are caught doing this sometimes still get to practice medicine, while others get caught in what very well might be an honest mistake.
published: 09 May 2017
-
Why Prescription Drugs Are Ridiculously Expensive
June 4 -- Drug spending in the U.S. totaled $330 billion in 2013, according to one estimate. By 2020, spending on specialty drugs alone could reach $400 billion. Bloomberg explains why the costs of prescription drugs, especially specialty medicines, can be so high.
published: 04 Jun 2015
-
Prescription for profit: what happens to dishonest doctors that cheat the Medicaid system
Some doctors who are caught doing this sometimes still get to practice medicine, while others get caught in what very well might be an honest mistake.
published: 08 May 2017
-
The Dangerous Risk of Taking Antibiotics Without a Prescription
Do you purchase antibiotics without a prescription? If so, watch this video, as we delve into the concerning rise of antibiotic resistance.
#AntibioticResistance #healthawareness #drpal #Antibioticproblem #healthyhabits #healthyeating #healthyeating #timerestrictedeating #intermittentfasting #90dayswithpal #askdocpal
-----
#90dayswithpal
Please join me in the 90-day challenge to transform our social media family towards a healthy 2024. Please log in to the website https://www.90dayswithpal.com/ and document your completion every day for the 7 days of the week. There will be giveaways for people who complete every day for the next 90 days.
-----
Medical comedy (Medcom) shows:
I love doing medical comedy (medcom) stand-up shows. This is a wonderful opportunity to meet you all in person ...
published: 05 Feb 2024
-
How to read Prescription I What is profit margin in Pharmacy
Happy to share we just launch ebook which covers all business opportunities after pharmacy which will become milestone for new people to enter into businessHere is link of video explaining everything about business--https://youtu.be/kXdfiWVnSjc
To purchase book pay 799/- to 9423272876 via google pay or PhonepayThen you instantly get eBook to email ID
---------------------------------------------------------------------------------------------------------------------------------------------------------For getting more info on Unacademy's Fast track revision
https://unacademy.com/batch/fast-track-revision-for-iit-jam-chemistry-batch-i/48IO4MM1
TO enroll Digital Course Please pay 999/- to 9423272876 via googlepay or phonepay
Then insrtantly you get all modules on your email ID
For more info...
published: 05 Dec 2020
-
Using Soil Tests to Improve Profit - TNC Ohio March Lunch & Learn
Hello! The TNC Ohio agriculture teams sits down with Clint Nester, an experienced agronomist, to discuss the ways that soil testing can increase a farmers profit. We do monthly lunch and learns and look forward to providing more informative content.
published: 25 Mar 2024
-
Health Insurance Carriers Are Prescription Drug Pushers
Health Insurance Carriers Are Prescription Drug Pushers. Or alternatively... how pharmaceutical payments to PBMs escape the Medical Loss Ratio.
For an example fully-insured group of 100 employees on the plan, the employer will pay approximately $1M per year in health insurance premiums.
85% of that premium must be spent on healthcare and 15% can be kept by the health insurance company for administration and profit margin.
However, prescription drug spend is approximately 20-25% of total healthcare spend. 25% of 85% is 21%... therefore, 21% of premium dollars are spent on prescriptions.
Approximately 25% of all drug spend comes back to the health insurance carrier in the form of pharmaceutical company 'rebates' (i.e. commissions). 25% or 21% is 5%... therefore, 5% of premium dollars c...
published: 07 May 2023
8:57
How the prescription drug supply chain is killing local pharmacies
The supply chain that brings pharmaceutical drugs from the factory to the pharmacy is long, complex and unclear. Congress and several state legislatures have pr...
The supply chain that brings pharmaceutical drugs from the factory to the pharmacy is long, complex and unclear. Congress and several state legislatures have proposed or enacted laws to bring more transparency and curb soaring drug prices. As special correspondent Fred de Sam Lazaro reports, many small or independent pharmacies complain the system also hurts them.
Stream your PBS favorites with the PBS app: https://to.pbs.org/2Jb8twG
Find more from PBS NewsHour at https://www.pbs.org/newshour
Subscribe to our YouTube channel: https://bit.ly/2HfsCD6
Follow us:
Facebook: http://www.pbs.org/newshour
Twitter: http://www.twitter.com/newshour
Instagram: http://www.instagram.com/newshour
Subscribe:
PBS NewsHour podcasts: https://www.pbs.org/newshour/podcasts
Newsletters: https://www.pbs.org/newshour/subscribe
https://wn.com/How_The_Prescription_Drug_Supply_Chain_Is_Killing_Local_Pharmacies
The supply chain that brings pharmaceutical drugs from the factory to the pharmacy is long, complex and unclear. Congress and several state legislatures have proposed or enacted laws to bring more transparency and curb soaring drug prices. As special correspondent Fred de Sam Lazaro reports, many small or independent pharmacies complain the system also hurts them.
Stream your PBS favorites with the PBS app: https://to.pbs.org/2Jb8twG
Find more from PBS NewsHour at https://www.pbs.org/newshour
Subscribe to our YouTube channel: https://bit.ly/2HfsCD6
Follow us:
Facebook: http://www.pbs.org/newshour
Twitter: http://www.twitter.com/newshour
Instagram: http://www.instagram.com/newshour
Subscribe:
PBS NewsHour podcasts: https://www.pbs.org/newshour/podcasts
Newsletters: https://www.pbs.org/newshour/subscribe
- published: 28 Jul 2023
- views: 45009
19:23
Cost of prescription drugs: Mayo Clinic Radio
Dr. Vincent Rajkumar is an internationally recognized researcher and has recently been diving into this important subject. He has published articles examining t...
Dr. Vincent Rajkumar is an internationally recognized researcher and has recently been diving into this important subject. He has published articles examining the origins of today’s drug pricing challenges and while these views represent his own perspective, Mayo Clinic is privileged to speak with him to discuss the complex considerations involved in this issue.
This interview originally aired on Mayo Clinic Radio May 11, 2019.
To listen to Dr. Rajkumar's Grand Rounds talk, visit: https://youtu.be/Rb9y6bBaEzo
https://wn.com/Cost_Of_Prescription_Drugs_Mayo_Clinic_Radio
Dr. Vincent Rajkumar is an internationally recognized researcher and has recently been diving into this important subject. He has published articles examining the origins of today’s drug pricing challenges and while these views represent his own perspective, Mayo Clinic is privileged to speak with him to discuss the complex considerations involved in this issue.
This interview originally aired on Mayo Clinic Radio May 11, 2019.
To listen to Dr. Rajkumar's Grand Rounds talk, visit: https://youtu.be/Rb9y6bBaEzo
- published: 11 May 2019
- views: 5596
16:11
The Prescription Profit Chain | Professor Speaks | Pro Pharma
Professor Speaks: Episode 41 -The Prescription Profit Chain
Topics Discussed Today:
1. The Prescription Profit Chain
Make sure to click "Subscribe" to receive...
Professor Speaks: Episode 41 -The Prescription Profit Chain
Topics Discussed Today:
1. The Prescription Profit Chain
Make sure to click "Subscribe" to receive notification of future videos.
Don't forget to submit your questions, which we will answer on our next video!
For the Latest News Visit: http://propharmaconsultants.com/rxinfox.html
Make sure you follow our company page on Facebook for the latest updates. https://www.facebook.com/propharmainc
Additional Resources:
Thank you for joining us!
See you next week!
https://wn.com/The_Prescription_Profit_Chain_|_Professor_Speaks_|_Pro_Pharma
Professor Speaks: Episode 41 -The Prescription Profit Chain
Topics Discussed Today:
1. The Prescription Profit Chain
Make sure to click "Subscribe" to receive notification of future videos.
Don't forget to submit your questions, which we will answer on our next video!
For the Latest News Visit: http://propharmaconsultants.com/rxinfox.html
Make sure you follow our company page on Facebook for the latest updates. https://www.facebook.com/propharmainc
Additional Resources:
Thank you for joining us!
See you next week!
- published: 23 Aug 2017
- views: 63
5:52
Prescription for profit: Hits and misses as state tries to crack down on Medicaid fraud
Some doctors who are caught doing this sometimes still get to practice medicine, while others get caught in what very well might be an honest mistake.
Some doctors who are caught doing this sometimes still get to practice medicine, while others get caught in what very well might be an honest mistake.
https://wn.com/Prescription_For_Profit_Hits_And_Misses_As_State_Tries_To_Crack_Down_On_Medicaid_Fraud
Some doctors who are caught doing this sometimes still get to practice medicine, while others get caught in what very well might be an honest mistake.
- published: 09 May 2017
- views: 88
2:07
Why Prescription Drugs Are Ridiculously Expensive
June 4 -- Drug spending in the U.S. totaled $330 billion in 2013, according to one estimate. By 2020, spending on specialty drugs alone could reach $400 billion...
June 4 -- Drug spending in the U.S. totaled $330 billion in 2013, according to one estimate. By 2020, spending on specialty drugs alone could reach $400 billion. Bloomberg explains why the costs of prescription drugs, especially specialty medicines, can be so high.
https://wn.com/Why_Prescription_Drugs_Are_Ridiculously_Expensive
June 4 -- Drug spending in the U.S. totaled $330 billion in 2013, according to one estimate. By 2020, spending on specialty drugs alone could reach $400 billion. Bloomberg explains why the costs of prescription drugs, especially specialty medicines, can be so high.
- published: 04 Jun 2015
- views: 5704
1:53
Prescription for profit: what happens to dishonest doctors that cheat the Medicaid system
Some doctors who are caught doing this sometimes still get to practice medicine, while others get caught in what very well might be an honest mistake.
Some doctors who are caught doing this sometimes still get to practice medicine, while others get caught in what very well might be an honest mistake.
https://wn.com/Prescription_For_Profit_What_Happens_To_Dishonest_Doctors_That_Cheat_The_Medicaid_System
Some doctors who are caught doing this sometimes still get to practice medicine, while others get caught in what very well might be an honest mistake.
- published: 08 May 2017
- views: 556
0:59
The Dangerous Risk of Taking Antibiotics Without a Prescription
Do you purchase antibiotics without a prescription? If so, watch this video, as we delve into the concerning rise of antibiotic resistance.
#AntibioticResista...
Do you purchase antibiotics without a prescription? If so, watch this video, as we delve into the concerning rise of antibiotic resistance.
#AntibioticResistance #healthawareness #drpal #Antibioticproblem #healthyhabits #healthyeating #healthyeating #timerestrictedeating #intermittentfasting #90dayswithpal #askdocpal
-----
#90dayswithpal
Please join me in the 90-day challenge to transform our social media family towards a healthy 2024. Please log in to the website https://www.90dayswithpal.com/ and document your completion every day for the 7 days of the week. There will be giveaways for people who complete every day for the next 90 days.
-----
Medical comedy (Medcom) shows:
I love doing medical comedy (medcom) stand-up shows. This is a wonderful opportunity to meet you all in person and also to promote awareness of a healthy lifestyle.
My upcoming show details:
📍Chennai - 7th Feb 2024
🔗 https://in.bookmyshow.com/events/dr-pal-live-laws-of-weight-loss-medcom-show/ET00384931?webview=true
📍Raleigh - 16th March 2024
🔗 https://www.tugoz.com/events/bldg18/medcom-show-raleigh
📍San Antonio - 6th April 2024
🔗 https://www.tugoz.com/events/bldg18/medcom-show-sa
-----
For Tamil videos, Subscribe to my YouTube channel:
https://www.youtube.com/channel/UCYxezj89xof3XRLFqly20VA
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Follow us on:
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Instagram: https://www.instagram.com/dr.pal.manickam/
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Telegram: https://t.me/Ask_Doc_Pal
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For Collabs & Enquiries:
Email: askdocpal@gmail.com
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Please donate to our non-profit Vanna Malargal Foundation, here are the details: https://www.vmfus.org/
#askdocpal #drpal #palaniappanmanickam #IntermittentFasting #WeightLossJourney #BellyFatLoss #TimeRestrictedEating
#IFResults #HealthyEating #IFCommunity #FastingForHealth #LoseWeight #FitLife #FatLossTips #MealTiming #IFGoals #BellyFatBusters #EatClean #IFSuccess #FitnessMotivation #BurnFat #HealthyHabits #MealPlan
https://wn.com/The_Dangerous_Risk_Of_Taking_Antibiotics_Without_A_Prescription
Do you purchase antibiotics without a prescription? If so, watch this video, as we delve into the concerning rise of antibiotic resistance.
#AntibioticResistance #healthawareness #drpal #Antibioticproblem #healthyhabits #healthyeating #healthyeating #timerestrictedeating #intermittentfasting #90dayswithpal #askdocpal
-----
#90dayswithpal
Please join me in the 90-day challenge to transform our social media family towards a healthy 2024. Please log in to the website https://www.90dayswithpal.com/ and document your completion every day for the 7 days of the week. There will be giveaways for people who complete every day for the next 90 days.
-----
Medical comedy (Medcom) shows:
I love doing medical comedy (medcom) stand-up shows. This is a wonderful opportunity to meet you all in person and also to promote awareness of a healthy lifestyle.
My upcoming show details:
📍Chennai - 7th Feb 2024
🔗 https://in.bookmyshow.com/events/dr-pal-live-laws-of-weight-loss-medcom-show/ET00384931?webview=true
📍Raleigh - 16th March 2024
🔗 https://www.tugoz.com/events/bldg18/medcom-show-raleigh
📍San Antonio - 6th April 2024
🔗 https://www.tugoz.com/events/bldg18/medcom-show-sa
-----
For Tamil videos, Subscribe to my YouTube channel:
https://www.youtube.com/channel/UCYxezj89xof3XRLFqly20VA
-----
Follow us on:
Facebook: https://www.facebook.com/Dr-Pal-102856268051377
Instagram: https://www.instagram.com/dr.pal.manickam/
Twitter: https://twitter.com/drpal_manickam
Telegram: https://t.me/Ask_Doc_Pal
-----
For Collabs & Enquiries:
Email: askdocpal@gmail.com
-----
Please donate to our non-profit Vanna Malargal Foundation, here are the details: https://www.vmfus.org/
#askdocpal #drpal #palaniappanmanickam #IntermittentFasting #WeightLossJourney #BellyFatLoss #TimeRestrictedEating
#IFResults #HealthyEating #IFCommunity #FastingForHealth #LoseWeight #FitLife #FatLossTips #MealTiming #IFGoals #BellyFatBusters #EatClean #IFSuccess #FitnessMotivation #BurnFat #HealthyHabits #MealPlan
- published: 05 Feb 2024
- views: 3890081
9:37
How to read Prescription I What is profit margin in Pharmacy
Happy to share we just launch ebook which covers all business opportunities after pharmacy which will become milestone for new people to enter into businessHere...
Happy to share we just launch ebook which covers all business opportunities after pharmacy which will become milestone for new people to enter into businessHere is link of video explaining everything about business--https://youtu.be/kXdfiWVnSjc
To purchase book pay 799/- to 9423272876 via google pay or PhonepayThen you instantly get eBook to email ID
---------------------------------------------------------------------------------------------------------------------------------------------------------For getting more info on Unacademy's Fast track revision
https://unacademy.com/batch/fast-track-revision-for-iit-jam-chemistry-batch-i/48IO4MM1
TO enroll Digital Course Please pay 999/- to 9423272876 via googlepay or phonepay
Then insrtantly you get all modules on your email ID
For more info contact us at mypharmacareer2@gmail.com
Or message me on my On istagram ID or facebook Page
Retail Pharmacy is one of successful business model in Pharma industry.This course is completely designed for all Non Pharma students, new entrepreneurs, existing people in pharma business. You can learn all things about retail pharmacy from scratch to advance level
This course divided into following modules with information
Module 1
You learn following things in this module
- What is pharmacy retail store?
-Benefits of retail pharmacy store
Module 2
It contains
-factors considering before starting new medical store
-Importance of location
Module 3
It contains
-How to apply for license
- Types of medicines
Module 4
It contains
-Importance of doctor
-Importance of chemist
- Importance of medical representative
- Importance of order boy
- Importance of delivery boy
- patient counseling
Module 5
It contains
- What is profit margin?
- How to maintain low expiry
-How to read prescription
Module 6
It contains
- First order medicine guideline
- How to maintain schedule drug register
Module 7
- How to start your own franchise business model
-How to start epharmacy from retail Pharmacy store
Module 8
It contains
-How to arrange medicines in retail store
-Details about franchise business model Health Expet
Read blog for more details-https://mypharmacareer.wordpress.com/2021/02/05/how-to-read-prescription-and-what-is-profit-margin-in-pharmacy/
To follow my channel
https://www.youtube.com/channel/UC5fCatIeN1X-_j3VXSe558w?view_as=subscriber
To follow our page on facebook
https://www.facebook.com/Things-by-Amit-105106854318204/?modal=admin_todo_tour
To follow our Pharma group on facebook
https://www.facebook.com/Pharma-career-837404819977037/?modal=admin_todo_tour
To follow on instagram
https://www.instagram.com/amitkumar_mane/
To follow on Twitter
https://twitter.com/ManeAmitkumar
To Follow On Linked In
https://www.linkedin.com/in/amitkumar-mane-9844b7180/
Our blog link
https://mypharmacareer.wordpress.com/
To Purchase my Books
https://www.instamojo.com/ThingsbyAmit/?ref=profile_bar
To have a complete digital course please visit
https://www.udemy.com/course/digital-course-on-retail-pharmacy-store/learn/
https://wn.com/How_To_Read_Prescription_I_What_Is_Profit_Margin_In_Pharmacy
Happy to share we just launch ebook which covers all business opportunities after pharmacy which will become milestone for new people to enter into businessHere is link of video explaining everything about business--https://youtu.be/kXdfiWVnSjc
To purchase book pay 799/- to 9423272876 via google pay or PhonepayThen you instantly get eBook to email ID
---------------------------------------------------------------------------------------------------------------------------------------------------------For getting more info on Unacademy's Fast track revision
https://unacademy.com/batch/fast-track-revision-for-iit-jam-chemistry-batch-i/48IO4MM1
TO enroll Digital Course Please pay 999/- to 9423272876 via googlepay or phonepay
Then insrtantly you get all modules on your email ID
For more info contact us at mypharmacareer2@gmail.com
Or message me on my On istagram ID or facebook Page
Retail Pharmacy is one of successful business model in Pharma industry.This course is completely designed for all Non Pharma students, new entrepreneurs, existing people in pharma business. You can learn all things about retail pharmacy from scratch to advance level
This course divided into following modules with information
Module 1
You learn following things in this module
- What is pharmacy retail store?
-Benefits of retail pharmacy store
Module 2
It contains
-factors considering before starting new medical store
-Importance of location
Module 3
It contains
-How to apply for license
- Types of medicines
Module 4
It contains
-Importance of doctor
-Importance of chemist
- Importance of medical representative
- Importance of order boy
- Importance of delivery boy
- patient counseling
Module 5
It contains
- What is profit margin?
- How to maintain low expiry
-How to read prescription
Module 6
It contains
- First order medicine guideline
- How to maintain schedule drug register
Module 7
- How to start your own franchise business model
-How to start epharmacy from retail Pharmacy store
Module 8
It contains
-How to arrange medicines in retail store
-Details about franchise business model Health Expet
Read blog for more details-https://mypharmacareer.wordpress.com/2021/02/05/how-to-read-prescription-and-what-is-profit-margin-in-pharmacy/
To follow my channel
https://www.youtube.com/channel/UC5fCatIeN1X-_j3VXSe558w?view_as=subscriber
To follow our page on facebook
https://www.facebook.com/Things-by-Amit-105106854318204/?modal=admin_todo_tour
To follow our Pharma group on facebook
https://www.facebook.com/Pharma-career-837404819977037/?modal=admin_todo_tour
To follow on instagram
https://www.instagram.com/amitkumar_mane/
To follow on Twitter
https://twitter.com/ManeAmitkumar
To Follow On Linked In
https://www.linkedin.com/in/amitkumar-mane-9844b7180/
Our blog link
https://mypharmacareer.wordpress.com/
To Purchase my Books
https://www.instamojo.com/ThingsbyAmit/?ref=profile_bar
To have a complete digital course please visit
https://www.udemy.com/course/digital-course-on-retail-pharmacy-store/learn/
- published: 05 Dec 2020
- views: 5295
36:07
Using Soil Tests to Improve Profit - TNC Ohio March Lunch & Learn
Hello! The TNC Ohio agriculture teams sits down with Clint Nester, an experienced agronomist, to discuss the ways that soil testing can increase a farmers profi...
Hello! The TNC Ohio agriculture teams sits down with Clint Nester, an experienced agronomist, to discuss the ways that soil testing can increase a farmers profit. We do monthly lunch and learns and look forward to providing more informative content.
https://wn.com/Using_Soil_Tests_To_Improve_Profit_Tnc_Ohio_March_Lunch_Learn
Hello! The TNC Ohio agriculture teams sits down with Clint Nester, an experienced agronomist, to discuss the ways that soil testing can increase a farmers profit. We do monthly lunch and learns and look forward to providing more informative content.
- published: 25 Mar 2024
- views: 31
6:41
Health Insurance Carriers Are Prescription Drug Pushers
Health Insurance Carriers Are Prescription Drug Pushers. Or alternatively... how pharmaceutical payments to PBMs escape the Medical Loss Ratio.
For an example ...
Health Insurance Carriers Are Prescription Drug Pushers. Or alternatively... how pharmaceutical payments to PBMs escape the Medical Loss Ratio.
For an example fully-insured group of 100 employees on the plan, the employer will pay approximately $1M per year in health insurance premiums.
85% of that premium must be spent on healthcare and 15% can be kept by the health insurance company for administration and profit margin.
However, prescription drug spend is approximately 20-25% of total healthcare spend. 25% of 85% is 21%... therefore, 21% of premium dollars are spent on prescriptions.
Approximately 25% of all drug spend comes back to the health insurance carrier in the form of pharmaceutical company 'rebates' (i.e. commissions). 25% or 21% is 5%... therefore, 5% of premium dollars come back to the health insurance carrier as payments from pharmaceutical companies.
This 5% of payments ESCAPES the Medical Loss Ratio, but still contributes to the health insurance carrier's profit margin.
Accordingly, health insurance carriers are financially incentivized for plan members to receive more and more expensive medications to boost the rebate payments and their bottom line profits.
**NOTE: It has been brought to my attention that CMS rules dictate in (42 CFR 438.8(e)(2)(ii)(B)) that "Amounts that must be deducted from incurred claims include the following: Prescription drug rebates received and accrued."
It is unknown if other pharmaceutical payments to PBMs such as Admin Fees, Formulary Placement Fees and Market Share Bonuses are considered 'rebates.'
Source: https://www.law.cornell.edu/cfr/text/42/438.8
Additional Sources:
https://civhc.org/2021/08/13/prescription-drug-rebates/
https://www.humirapro.com/patient-support
AHealthcareZ PBM Money Flow Video: https://youtu.be/vT0NNXYjQ_Y
AHealthcareZ is 400+ Healthcare Finance Educational Videos.
💥 BOOK: Check out Dr. Bricker’s Book 16 Lessons in the Business of Healing here: https://www.ahealthcarez.com/healthcare-money-campfire-stories-book
AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health.
100,000+ Views Per Month Across All Platforms.
Visit AHealthcareZ.com to Subscribe to the Healthcare Finance Video Newsletter.
https://wn.com/Health_Insurance_Carriers_Are_Prescription_Drug_Pushers
Health Insurance Carriers Are Prescription Drug Pushers. Or alternatively... how pharmaceutical payments to PBMs escape the Medical Loss Ratio.
For an example fully-insured group of 100 employees on the plan, the employer will pay approximately $1M per year in health insurance premiums.
85% of that premium must be spent on healthcare and 15% can be kept by the health insurance company for administration and profit margin.
However, prescription drug spend is approximately 20-25% of total healthcare spend. 25% of 85% is 21%... therefore, 21% of premium dollars are spent on prescriptions.
Approximately 25% of all drug spend comes back to the health insurance carrier in the form of pharmaceutical company 'rebates' (i.e. commissions). 25% or 21% is 5%... therefore, 5% of premium dollars come back to the health insurance carrier as payments from pharmaceutical companies.
This 5% of payments ESCAPES the Medical Loss Ratio, but still contributes to the health insurance carrier's profit margin.
Accordingly, health insurance carriers are financially incentivized for plan members to receive more and more expensive medications to boost the rebate payments and their bottom line profits.
**NOTE: It has been brought to my attention that CMS rules dictate in (42 CFR 438.8(e)(2)(ii)(B)) that "Amounts that must be deducted from incurred claims include the following: Prescription drug rebates received and accrued."
It is unknown if other pharmaceutical payments to PBMs such as Admin Fees, Formulary Placement Fees and Market Share Bonuses are considered 'rebates.'
Source: https://www.law.cornell.edu/cfr/text/42/438.8
Additional Sources:
https://civhc.org/2021/08/13/prescription-drug-rebates/
https://www.humirapro.com/patient-support
AHealthcareZ PBM Money Flow Video: https://youtu.be/vT0NNXYjQ_Y
AHealthcareZ is 400+ Healthcare Finance Educational Videos.
💥 BOOK: Check out Dr. Bricker’s Book 16 Lessons in the Business of Healing here: https://www.ahealthcarez.com/healthcare-money-campfire-stories-book
AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health.
100,000+ Views Per Month Across All Platforms.
Visit AHealthcareZ.com to Subscribe to the Healthcare Finance Video Newsletter.
- published: 07 May 2023
- views: 1730