Update: Walmart, CVS Health Settle Pharmacy Feud

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Update:

LITTLE ROCK, Ark. (Fox Business)- CVS Health announced Friday it has reached terms with Walmart on a deal that will keep the big-box retailer as part of its pharmacy network, resolving a dispute over the cost of filling prescriptions.

The two companies said they had made a “multi-year agreement” for Walmart to participate in the CVS Caremark and Managed Medicaid pharmacy benefit networks. Without a deal, those plans would have stopped covering the cost of prescriptions filled at Walmart pharmacies, meaning employees reliant on CVS Caremark drug benefits and Medicaid recipients would not be reimbursed.

“We are very pleased to have reached a mutually agreeable solution with Walmart. As a PBM, our top priority is to help our clients and consumers lower their pharmacy costs,” CVS Caremark President Derica Rice said in a statement. “This new agreement accomplishes our top priority and enables Walmart to continue participating in CVS Caremark’s commercial and Managed Medicaid pharmacy networks and provides enhanced network stability for our clients and their members.”

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Original:

LITTLE ROCK, Ark. (News Release) – CVS Health announced Tuesday that Walmart has notified the company of its intention to leave the CVS Caremark pharmacy benefit management (PBM) commercial and Managed Medicaid retail pharmacy networks due to an ongoing pricing dispute. Patients with CVS-administered drug benefits (including Arkansas Blue Cross Blue Shield) and Medicaid enrollees with CVS drug coverage may no longer be able to have their prescriptions filled at Walmart stores if the retailer follows through with the announcement. “It’s no surprise to Arkansas pharmacists how PBMs operate, but last year patients got their first look behind the curtain of the pharmacy benefits management industry when many of them weren’t able to use their pharmacist of choice because PBMs weren’t paying a fair price,” Arkansas Pharmacists Association COO John Vinson said. “Now, the world’s largest retailer is leaving the CVS network because of the challenges that Arkansas pharmacies have been facing for years.”

In early 2018, Arkansas pharmacists had their own battle with CVS/Caremark and other PBMs when they slashed reimbursement prices that pharmacists receive when they fill a prescription. In many cases, CVS/Caremark was reimbursing independent pharmacists at a rate lower than the pharmacy paid to purchase the medication, while paying their own CVS pharmacies at rates much higher, keeping the money in their own pockets. In addition, CVS and other large pharmacy benefit managers routinely use anticompetitive tactics to steer patients to themselves – their PBM owned mail order and PBM owned retail pharmacies – disrupting the patient’s control over their own healthcare and creating a “heads, we win/tails, you lose” approach to patients and benefit design. After months of lowered reimbursements and pharmacies on the verge of shutting down, a concerted effort of pharmacists, legislators, and patients led the governor to call a special legislative session to sign emergency legislation that would require PBMs operating in the state of Arkansas to be licensed, allowing the Insurance Department to oversee the previously unregulated and unmonitored PBM industry.

“A healthy market and fair competition lead to better prices and better health outcomes,” Vinson said. “A broken market leads to financial enrichment of monopolies. For example, according to a recent Wall Street Journal article, PBMs overcharged taxpayers by $9.1 billion through Medicare Part D. Arkansas legislators worked swiftly and effectively to make Arkansas a national leader on PBM reform; it’s time for CMS and Congress in Washington, D.C. to take action to protect taxpayers and patients.”

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