PBMs Increasing The Price of Epipen And Insulin

PBMs Increasing The Price of Epipen And Insulin

  April 24, 2023    MDubPharmD

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Pharmacy Benefit Managers and the High Cost of Epiens: An Overview

Pharmacy Benefit Managers (PBMs) are third-party administrators of prescription drug programs for health plans, insurance companies, and self-insured employers. PBMs negotiate drug prices with manufacturers and set reimbursement rates for pharmacies, and are therefore instrumental in determining the cost of prescription drugs. In recent years, the high cost of certain prescription drugs, including Epipens, has been linked to the practices of PBMs.

Epipens are devices used to administer epinephrine in cases of severe allergic reactions. The cost of Epipens has risen dramatically in recent years, from around $100 for a two-pack in 2009 to over $600 in 2016. This steep increase in cost has led to concerns about access to lifesaving medication for patients with severe allergies.

One factor contributing to the high cost of Epipens is the role of PBMs. PBMs negotiate prices with drug manufacturers and set reimbursement rates for pharmacies, and they have been accused of using their market power to drive up prices for medications like Epipens. PBMs may negotiate lower prices with drug manufacturers, but then charge higher prices to health plans or employers, effectively increasing the cost of medications for patients. Additionally, PBMs may favor certain medications over others based on factors such as rebates, which can lead to higher costs for patients.

In the case of Epipens, PBMs have been accused of favoring Mylan, the manufacturer of Epipens, over competitors. Mylan reportedly paid PBMs large rebates in exchange for preferential treatment in formularies, which are lists of medications that are covered by a particular health plan. This means that patients were more likely to be prescribed Epipens, even though there were other, less expensive alternatives available.

The high cost of Epipens is not an isolated issue, and PBMs have been linked to other cases of increased drug prices. For example, PBMs have been accused of contributing to the high cost of insulin, which is essential for the treatment of diabetes. Like Epipens, the cost of insulin has risen significantly in recent years, making it difficult for many patients to afford.

While PBMs play an important role in managing prescription drug programs, their practices have come under scrutiny in recent years. Critics argue that PBMs lack transparency and accountability, and that their practices contribute to the high cost of prescription drugs. Some have called for increased regulation of the PBM industry to ensure that patients have access to affordable medications.

In conclusion, the high cost of Epipens and other prescription drugs is a complex issue that involves many factors, including the role of PBMs. PBMs have been accused of contributing to the high cost of Epipens and other medications through practices such as preferential treatment for certain manufacturers and the use of rebates. As the debate over prescription drug costs continues, it is important to consider the role of PBMs in the pricing of medications and to advocate for greater transparency and accountability in the industry.

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Pharmacy Benefit Managers Increasing The Cost of Medication

Pharmacy Benefit Managers Increasing The Cost of Medication

  April 23, 2023    MDubPharmD

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 Pharmacy Benefit Managers Increasing the Cost of Medication: Understanding the Issue

Pharmacy Benefit Managers (PBMs) are companies that manage prescription drug programs for health plans, insurance companies, and self-insured employers. PBMs are responsible for negotiating prices with drug manufacturers, setting reimbursement rates for pharmacies, and creating formularies, which are lists of medications that are covered by a particular health plan. While PBMs were initially created to help reduce the cost of prescription drugs, some have argued that they are actually contributing to the rising cost of medication in the United States.

One of the ways that PBMs increase the cost of medication is by using a practice called "spread pricing". Spread pricing occurs when PBMs negotiate a lower price for a medication with a drug manufacturer, but then charge the health plan or employer a higher price for the same medication. The difference between the lower price negotiated with the manufacturer and the higher price charged to the health plan or employer is called the "spread". PBMs are not required to disclose the amount of the spread, which can be significant. This means that health plans and employers may be paying much more for medications than they need to, which can lead to higher premiums or cost-sharing for patients.

Another way that PBMs increase the cost of medication is through rebates. PBMs negotiate rebates with drug manufacturers, which are discounts off the list price of a medication. While these rebates can help reduce the overall cost of medications, they can also lead to higher prices for patients. This is because PBMs may encourage the use of medications that offer higher rebates, rather than medications that are more affordable or effective for patients. Additionally, PBMs may keep a portion of the rebate for themselves, rather than passing the full savings on to the health plan or employer.

PBMs have also been accused of creating and promoting formularies that favor higher-priced medications over lower-priced alternatives. This can lead to patients being prescribed more expensive medications, even when a lower-priced alternative is available and just as effective. PBMs may do this because they receive a percentage of the amount paid for each prescription, which means that they may have an incentive to promote higher-priced medications.

Overall, the issue of PBMs increasing the cost of medication is complex and multifaceted. While PBMs may have originally been created to help reduce the cost of prescription drugs, some argue that their practices are actually contributing to the rising cost of medication in the United States. If you are concerned about the cost of your medications, it's important to speak with your healthcare provider and insurance company to understand how PBMs are affecting your prescription drug coverage. Additionally, you may want to consider advocating for increased transparency and accountability in the PBM industry, so that patients can better understand how their prescription drug coverage is being managed.

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Way to Lose Weight and Keep it Off

Way to Lose Weight and Keep it Off

  April 19, 2023    MDubPharmD

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Losing weight can be a difficult and challenging process, but it is possible to achieve long-term weight loss success. In this article, we will discuss different diets, the mental approach, and how to sustain weight loss.

Different Diets

There are many different diets and weight loss programs available, each with their own approach and guidelines. Some popular diets include:

1. Low-carb diets: These diets restrict carbohydrates, such as bread, pasta, and sugar, and emphasize protein and healthy fats.

2. Mediterranean diet: This diet emphasizes whole, plant-based foods, healthy fats, and lean proteins, such as fish.

3. Intermittent fasting: This approach involves limiting food intake to specific periods of time, such as only eating during an 8-hour window each day.

4. Low-fat diets: These diets limit fat intake and emphasize lean proteins, fruits, and vegetables.

5. Plant-based diets: These diets focus on whole, plant-based foods, such as fruits, vegetables, nuts, and seeds.

The Mental Approach

Weight loss is not just about following a diet or exercise plan; it also requires a mental shift and a change in behavior. Some tips for adopting a healthy mental approach to weight loss include:

1. Setting realistic goals: It's important to set achievable goals and to focus on progress, not perfection.

2. Building healthy habits: Small, sustainable changes in behavior can lead to long-term weight loss success.

3. Finding support: Joining a weight loss group or working with a therapist can provide accountability and encouragement.

4. Practicing self-care: Prioritizing self-care, such as getting enough sleep and managing stress, can help support weight loss efforts.

Sustaining Weight Loss

Once weight loss goals are achieved, it's important to maintain the weight loss to prevent regain. Some tips for sustaining weight loss include:

1. Continuing healthy habits: Continue to eat a balanced diet and engage in regular exercise to maintain weight loss.

2. Monitoring progress: Regularly weighing oneself and tracking food intake and exercise can help maintain accountability.

3. Managing stress: Stress can lead to emotional eating and weight regain, so finding healthy ways to manage stress is important.

4. Building a support system: Maintaining a support system can provide encouragement and accountability.

In conclusion, achieving long-term weight loss success requires a combination of different diets, a healthy mental approach, and sustained efforts to maintain weight loss. By adopting healthy habits, managing stress, and finding support, it is possible to achieve and maintain a healthy weight for the long-term. 

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Overview and Treatment of a Heart Attack

Overview and Treatment of a Heart Attack

  April 19, 2023    MDubPharmD

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A heart attack, also known as myocardial infarction, is a serious medical emergency that occurs when the blood flow to the heart is blocked, causing damage to the heart muscle. In this article, we will discuss what a heart attack is, how to treat it, preventative measures prescribed to patients to prevent another heart attack from occurring, dangers of not seeking treatment, and non-pharmacologic ways to help prevent another heart attack from occurring.

What is a Heart Attack?

A heart attack occurs when the blood flow to the heart is blocked, usually by a blood clot. This can happen when the arteries that supply blood to the heart become narrowed and hardened by a buildup of cholesterol and other substances. When the blood flow to the heart is blocked, the heart muscle can become damaged or die, which can lead to serious complications or even death.

How to Treat a Heart Attack

A heart attack is a medical emergency, and immediate treatment is crucial. The following steps should be taken if someone is experiencing a heart attack:

1. Call for emergency medical assistance.

2. Administer aspirin, which can help prevent further blood clots.

3. Administer nitroglycerin, which can help improve blood flow to the heart.

4. Begin cardiopulmonary resuscitation (CPR) if the person stops breathing or their heart stops beating.

5. If necessary, perform defibrillation, which can help restore a normal heart rhythm.

Preventative Measures Prescribed to Patients to Prevent Another Heart Attack

After a heart attack, patients are typically prescribed a combination of medications and lifestyle changes to help prevent another heart attack from occurring. These may include:

1. Medications to reduce the risk of blood clots, such as aspirin, clopidogrel, or heparin.

2. Medications to lower blood pressure, such as beta-blockers or ACE inhibitors.

3. Medications to lower cholesterol, such as statins.

4. Lifestyle changes such as quitting smoking, eating a healthy diet, exercising regularly, and reducing stress.

Dangers of Not Seeking Treatment

Not seeking treatment for a heart attack can be extremely dangerous, and can lead to serious complications or even death. The longer the heart muscle is deprived of oxygen, the more damage can occur. In some cases, the damage can be irreversible, leading to heart failure, arrhythmias, or even sudden death.

Non-Pharmacologic Ways to Help Prevent Another Heart Attack

In addition to medication and lifestyle changes, there are several non-pharmacologic ways to help prevent another heart attack from occurring, including:

1. Quitting smoking: Smoking is a major risk factor for heart disease, and quitting smoking can significantly reduce the risk of another heart attack.

2. Eating a healthy diet: Eating a diet that is low in saturated fat, cholesterol, and salt can help reduce the risk of heart disease.

3. Exercising regularly: Regular exercise can help improve heart health and reduce the risk of heart disease.

4. Reducing stress: High levels of stress can increase the risk of heart disease, so finding ways to reduce stress, such as practicing relaxation techniques, can be beneficial.

In conclusion, a heart attack is a serious medical emergency that requires immediate treatment. Preventative measures, such as medication and lifestyle changes, are prescribed to patients to help prevent another heart attack from occurring. Not seeking treatment for a heart attack can be extremely dangerous, and can lead to serious complications or even death. Non-pharmacologic ways to help prevent another heart attack from occurring include quitting smoking, eating a healthy diet, exercising regularly, and reducing stress.

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Asthma Disease Overview

Asthma Disease Overview

  April 19, 2023    MDubPharmD

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Asthma is a chronic respiratory disease that affects millions of people worldwide. It is characterized by inflammation and narrowing of the airways, which can cause symptoms such as wheezing, coughing, and shortness of breath. In this article, we will discuss what asthma is, the medications used to treat it, how to treat an acute asthma exacerbation, and non-pharmacologic ways to control it.

What is Asthma?

Asthma is a chronic respiratory disease that affects the airways in the lungs. It is characterized by inflammation and narrowing of the airways, which can cause symptoms such as wheezing, coughing, and shortness of breath. Asthma can be triggered by a variety of factors, including allergens, exercise, cold air, and respiratory infections.

Medications Used to Treat Asthma

There are several types of medications used to treat asthma, including:

1. Inhaled corticosteroids (ICS): These medications work by reducing inflammation in the airways, making it easier to breathe. ICS are often used as a long-term treatment for asthma.

2. Short-acting beta-agonists (SABAs): These medications work by relaxing the muscles in the airways, making it easier to breathe. SABAs are often used as a quick-relief treatment for asthma symptoms.

3. Long-acting beta-agonists (LABAs): These medications work in a similar way to SABAs, but their effects last longer. LABAs are often used in combination with ICS as a long-term treatment for asthma.

4. Leukotriene modifiers: These medications work by blocking the action of leukotrienes, which are chemicals that can cause inflammation in the airways. Leukotriene modifiers are often used as a long-term treatment for asthma.

5. Immunomodulators: These medications work by modifying the immune system's response to allergens, which can help reduce inflammation in the airways. Immunomodulators are often used as a long-term treatment for severe asthma.

Treating an Acute Asthma Exacerbation

An acute asthma exacerbation, also known as an asthma attack, can be a life-threatening emergency. The following steps should be taken if someone is experiencing an asthma attack:

1. Administer a quick-relief medication, such as a short-acting beta-agonist (SABA).

2. Have the person sit up and lean forward to help improve breathing.

3. Encourage the person to take slow, deep breaths.

4. If the person's symptoms do not improve, call for emergency medical assistance.

Non-Pharmacologic Ways to Control Asthma

In addition to medication, there are several non-pharmacologic ways to control asthma, including:

1. Avoiding triggers: Identifying and avoiding triggers such as allergens, exercise, and respiratory infections can help prevent asthma symptoms.

2. Breathing exercises: Breathing exercises such as pursed lip breathing and diaphragmatic breathing can help improve lung function and reduce asthma symptoms.

3. Regular exercise: Regular exercise can help improve lung function and reduce asthma symptoms, as long as it is done in a controlled environment and with proper medical guidance.

4. Maintaining a healthy weight: Being overweight or obese can worsen asthma symptoms, so maintaining a healthy weight can be beneficial for people with asthma.

In conclusion, asthma is a chronic respiratory disease that can cause significant symptoms and impact quality of life. Treatment for asthma includes medications such as inhaled corticosteroids, short-acting beta-agonists, and leukotriene modifiers. In the event of an acute asthma exacerbation, quick-relief medications such as short-acting beta-agonists should be administered, and emergency medical assistance should be sought

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