J Cates retweeted
💙 “It feels so good to be able to offer [services] and take care of the patients that normally are not being taken care of...”
In a new documentary, NCPA examines the pharmacy desert crisis in Milwaukee through the eyes of independent community pharmacists who are filling in the gaps.
🎥 Watch in full: youtu.be/3KR1BOw38ac
J Cates retweeted
New Mark Cuban / 3 Axis Advisors study shows NADAC plus $12 dispensing fee could reduce commercial PBM generic drug charges by 20% or $5.44 per claim. See page 21 @CmrChaNJ
static1.squarespace.com/stat…
J Cates retweeted
Really pharmacists... 32 replies on a national pharmacy RFI? 32!? Please share and give feedback.
federalregister.gov/document…
J Cates retweeted
Your peptides may be coming fentanyl suppliers.
Anhui Renchen Technology was indicted in 2023 for supplying the Sinaloa Cartel with fentanyl precursors.
Their website currently sells semaglutide and melanotan II.
Of roughly 200 Chinese firms TRM Labs tracked selling fentanyl precursors, at least 50 now sell peptides.
The shipments enter the US in “master cartons” mislabelled as snack food, broken up by a domestic handler and mailed on. CBP has intercepted around 400 of those operations and seized over 130,000 vials in the past year.
FDA records surfaced showing two deaths, one in July and one in September, reported after people injected untested black market retatrutide.
J Cates retweeted
BREAKING: FDA inspectors discovered black mold, bugs, and “gross contamination” at a Chinese plant making ingredients for compounded GLP-1 drugs.
J Cates retweeted
BREAKING NEWS: Abdul El-Sayed Campaign Official Reveals El-Sayed Receives Overseas Donations, Admits Foreign Contributions Are Illegal Under Federal Law, Warns Denouncing Hamas Could Cost Support
“You know, he [Abdul El-Sayed] has people from overseas that donate to him...No it is not allowed."
“He [Abdul El Sayed] can't just say, you know, no, I don't support Hamas, you know, I reject all of them, because he's going to lose the people that brought him up in the first place.”
@AbdulElSayed @MikeRogersForMI
J Cates retweeted
This is what practicing medicine without a license looks like. Physicians are getting orders sent to patients without their consent and without their knowledge. If I did something like that I'd have my name slapped on a lawsuit by way of a federal grand jury indictment....
Story Time: Buckle up for this one.
Patient called today pissed off. They weren’t pissed at me, more so pissed at their insurance company @DevotedHealth and @CVSHealthPBM
For the past month, @DevotedHealth has been pestering them about switching their medications over to their mail order @CVSHealthPBM
First it was atorvastatin and Jardiance, because they said the patient would have “cheaper” copays.
The patient called us to verify those prices.
Our prices were identical to what they would have paid at mail order.
Patient told @CVSHealthPBM NO!
They wanted to stay local.
A few days later, patient gets a message from @CVSHealthPBM stating they had two prescriptions waiting to be sent to the patient. Just needed the go ahead to mail them out.
It was for the same 2 prescriptions they had said no to a few days prior.
Patient called them back and told them no, they want to continue getting them locally…. That was the end of it.
Until today…
Patient called back and said now @CVSHealthPBM has another prescription for metformin ready for me and has already mailed it out.
It’s a prescription we have been filling at our independent pharmacy all of this calendar year at a $0 copay.
Patient told them, I didn’t authorize you to get this prescription ready for me at mail order, how did you receive the prescription?
@CVSHealthPBM told them that their Dr. had authorized a new prescription for them.
Patient calls their Dr.
Dr. states they never sent a prescription to mail order @CVSHealthPBM
So, let me sum this up and put a nice little bow on it for you:
@CVSHealthPBM requested a new prescription from patient’s Dr. without their consent.
@CVSHealthPBM prepared the new prescription for patient without their consent.
And finally, @CVSHealthPBM mailed out the prescription for the patient without their consent.
I don’t know who is ultimately at fault for this, but it’s damn sure not the patient…
The patient keeps saying NO, but @CVSHealthPBM says we don’t give a shit, we’re going to do it anyway.
@CMSGov @DrOzCMS @RobertKennedyJr @realDonaldTrump
J Cates retweeted
UnitedHealth Group’s profits just jumped 75% to *$4.1 BILLION* in a single quarter.
Earlier this week, I dug into its latest earnings report and what executives said on their call with Wall Street analysts.
Here's what stood out:
healthcareuncovered.substack…
J Cates retweeted
Quick update for this saga…
Patient called back today with their newly-issued mail-order prescription in hand.
The prescription in question wasn’t even written by their primary physician.
It came from a prescriber they had never heard of/or seen.
I researched the provider on my own, come to find out they have 2 practice addresses: 1 in Ohio and the other in Eagan, MN. PO BOX 211699
Guess who is located in Eagan, MN?
Devoted Medical Group Professional Corporation and related Devoted Medical practices.
So, @DevotedHealth utilized one of their very own physicians to issue a fraudulent prescription for a patient who they’ve never seen or even knew.
Then shipped it off to the patient without their consent, thinking the patient wouldn’t question it?
Wow.
J Cates retweeted
Being a dad is just telling yourself “it’s been an expensive month, we’ll get back on track next month” over and over again until you die
J Cates retweeted
It’s 2075. There is only one hospital in the entire country. It is 8 square miles in the middle of Kansas and owned by United Healthcare. Premiums are $47,000 per month. The only medications left are Ozempic and boner pills. Life expectancy is 38.
Government: “I can’t believe doctors did this to us.”
J Cates retweeted
General Medicine has raised a $120M Series B led by @a16z. We're using it to build the healthcare store.
The only way healthcare will work is to make the customer the most powerful participant in the system. And the only way to do that is to let them shop.
Here’s why healthcare needs a store, and what we had to build to make it possible:
J Cates retweeted
Your pharmacy. Your choice. 💊
H.R. 6610, the Pharmacists Fight Back Act, protects patient choice, lowers prescription costs, and stops PBM tax dollar waste to keep pharmacies open.
Tell your legislator to support H.R. 6610: bit.ly/44WZYAg
#PharmacistsFightBack
J Cates retweeted
Well, this is officially peak life as a man.
Been a dad for less than 12 hours. Haven’t slept in 2 days. As a mf who has basically done it all and seen it all by 29, I’m telling you…becoming a father is the peak.
You don’t need the millions. You don’t need the cars, the watches, the businesses. If you have ever held your own son or daughter you’re already in the 1%.
If you don’t have kids? You’re unfortunately missing out on the greatest blessing there is. I really don’t know how else to say it tbh.
My daughter in my arms. My superwoman of a fiancée in the bed sleeping.
Just feeling these little fingers grasp my pinky to soothe herself to sleep is worth more than any deal or any car or any business.
Makes every single one of these unread emails or business “problems” I have feel completely insignificant.
Sure, one can love the game. Purpose, passion, philosophy, politics, these are important facets of living a full life as a man.
But fatherhood?
This is the peak.
J Cates retweeted
What happens when the company managing your pharmacy benefits also owns the pharmacy competing with your local independent pharmacy?
That is the issue this reel is raising.
CVS Health owns Aetna, Caremark, and CVS Pharmacy.
That means one corporate system can influence insurance coverage, pharmacy benefits, reimbursement, and pharmacy ownership.
For independent pharmacies, that can create a major imbalance.
The video explains that many contracts offered by the biggest PBMs can feel like “take it or leave it” agreements.
And when three PBMs control roughly 80% of the market, independent pharmacies may have very little room to negotiate.
So even when a local pharmacy offers better service, stronger relationships, and personalized care, it may still struggle because of the reimbursement terms it receives.
This is why PBM reform is also a competition issue.
Patients deserve real pharmacy choice, and independent pharmacies deserve a fair chance to compete.
What do you think? 👇
Can there be fair competition when PBMs also own the pharmacies they are competing with?
@SenKatieBritt @SenTuberville @RepTerriSewell @USRepGaryPalmer @RepBarryMoore @RepSCFigures @RepMikeRogersAL @Robert_Aderholt @RepDaleStrong @_Apci @TruthRx @COMMPHARMACY
#PBMReform #VerticalIntegration #CommunityPharmacy #HealthcareCompetition #PatientsFirst #DrugPricing #SupportIndependentPharmacy
J Cates retweeted
Pharmacy spending can touch a dozen stakeholders in the drug channel.
Here's where $1 million in spending actually goes.
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@AHIPCoverage's recent breakdown of prescription drug spending assigns every cent of a prescription dollar to somewhere in the drug channel.
To make it more tangible, I converted it into a Sankey diagram for a plan with $1 million in pharmacy spending:
💊 Drugmakers retain $504k of every dollar
💰 $275k flows back out as rebates that lower premiums and government drug costs
🏥 $177k goes to the supply chain: pharmacies, providers, and wholesalers
📋 $44k covers PBM and health plan operating costs and profit
---
That $504k to the manufacturer isn't just profit. It splits into brand manufacturer production costs, sales and advertising, R&D, generic manufacturer revenue, brand manufacturer profit, and taxes, fees, and other costs.
Brand manufacturer profit is $65k = half of the $126k in 340B margin and five times larger than the $13k health plans and PBMs keep as profit.
Worth noting: AHIP is a health plan advocacy/trade group. That's not a reason to dismiss the numbers, but it's relevant context.
---
No single business is pocketing all the pharmacy spending here.
Manufacturers, PBMs, health plans, pharmacies, providers, wholesalers, and 340B entities are all taking a piece of the total pharmacy spending, just very different sized pieces.
If you had to redesign this dollar allocation from scratch, which stakeholder is getting a bigger chunk than you think they should?
🔗 Source: AHIP ahiporg-production.s3.amazon…
