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How Obamacare Pushes Big Pharma To Overcharge You For Prescriptions

I found out firsthand: big conglomerates make profits by keeping the system complicated, bureaucratic, and opaque.

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As if our health care “system” wasn’t already complicated enough, here’s example No. 9,572.

I spent the better part of one year trying to ask a prescription drug provider one simple question about my prescription. Even as someone who works in health policy and with advocates on my behalf, I kept getting the run-around.

Unfortunately, as I found out firsthand, big conglomerates — in this case, CVS Health — make profits by keeping the system complicated, bureaucratic, and opaque. But (eventually) I found out there’s a simple solution: returning to good, old-fashioned cash transactions.

The saga started last summer, when my physician prescribed a maintenance medication to prevent a recurrence of kidney stones. My doctor sent a prescription to CVS Caremark, requesting a 90-day mail-order supply of the drug. CVS is the pharmaceutical benefits manager (PBM) that administers my prescription.

When it arrived, I received the following note:

We filled your prescription with a smaller quantity than what your doctor prescribed. Your prescription plan has limits on the amount of your medication it will cover. We filled your prescription according to these limits. [Emphasis original.]

We filled your prescription with a smaller quantity than what your doctor prescribed. Your prescription plan has limits on the amount of your medication it will cover. We filled your prescription according to these limits. [Emphasis original.]

For the better part of 12 months, I communicated with CVS staff, trying to figure out the reasons for this decision. I also asked a representative from the District of Columbia’s Office of Health Care Ombudsman to investigate on my behalf. Every time my physician prescribed a 90-day supply of this medication, CVS Caremark sent me a 30-day supply of the drug, along with the........

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