Tuesday, August 01, 2023

When Mark Cuban Cost Plus Drug Company Says Your Prescription is "Out of stock"

My followers may recall that about a year ago (on August 22, 2022), I blogged about (see https://blog.sstrumello.com/2022/08/generic-crestor-pricing-insanity.html for the post) how I had made a conscious decision to simply disintermediate my own insurance pharmacy benefit to buy an inexpensive generic statin drug because my own pharmacy benefit manager was ripping me off. Currently, I'm covered by Aetna which is now owned by CVS Health, which also owns the  PBM known as Caremark. 

Caremark was robbing me on the statin. It was overcharging me. They were trying to charge me $33.85 (or $0.38 per tablet) for a 90-day supply of a cheap generic drug which was made in India. USC researchers found that for almost one quarter of filled pharmacy prescriptions (23%) involved a patient co-payment that exceeded the average reimbursement paid by the insurer (and their PBM) by more than $2.00. In other words, PBMs were screwing covered patients about one-quarter of the time (see https://healthpolicy.usc.edu/research/overpaying-for-prescription-drugs/ for the research). Most typically, the "spread pricing" occurs on inexpensive generic drugs, rather than costly branded drugs. But I knew I was being screwed, so I bypassed my insurance. It was easy. 

Until it wasn't as easy any more.

Initially, I bought the drug from Caremark's biggest rival: United Healthcare's OptumRx. I paid $0.17/tablet with Optum, saving me 56%. But about a year later, United Healthcare sold its cash retail pharmacy business known as Optum Store (as well as its coupon generating website/app known as OptumPerks) to RVO Health LLC, which was also the entity which acquired the old DiabetesMine blog (at least indirectly, it acquired what was known as Healthline, which previously ran DiabetesMine until it shut that down). I blogged about how United Healthcare had sold its direct-to-consumer pharmacy business at https://blog.sstrumello.com/2023/05/optum-store-opting-out-of-direct-to.html if you care to read the details. Optum Store inexplicably raised its statin price by 40% on rosuvastatin calcium 10 mg tablets from $15 to $21. Maybe it was because Optum Store no longer had access to OptumRx thievery. I don't know. But I was forced to either pay 40% more, or find an alternative.

Anyway, I had been happily doing business with Mark Cuban Cost Plus Drug Company to buy my statin for a fully-loaded price of $10.70 (and that price included $5 for shipping) which equated to a price of $0.12/tablet compared to the $0.38/tablet Caremark intended to charge me, until I recently went to re-order that, and then I ran into a problem: the drug, which Mark Cuban Cost Plus Drug Company had sourced from from Novadoz Pharmaceuticals, LLC (which is a Piscataway, New Jersey-based generic drug company, that company relied on contract manufacturers with suppliers located in India.) Anyway, when I tried to refill my script for generic Crestor, I got a message which said "Status: Out of stock: Your medication is currently out of stock and we do not have an ETA at this time, If you need your medication sooner than that, please contact our customer support for help."

That was weird. 

Truth be told, I didn't really NEED the drug at the moment. I already have a number of bottles I could safely rely on for about a year. But I didn't like being sent an email reminder indicating it was time to refill a script, then going to do that, and being told the medicine was out of stock without an estimated time of arrival. Its anyone's guess when that might be.

So what do I do next? 

Well, as I said, I'm not really running out of the drug. Luckily, I have plenty in inventory because I stocked-up when a previous insurer (Cigna) gave it to me at no charge. But I continue to find that statin drugs are curiously overpriced. Costco wasn't really a viable option at the time I looked. One reason was because Costco suddenly stopped working with another PBM-powered coupon app known as Capital Rx Advantage Savings https://capitalrxadvantage.com/, hence Costco's prices on the generic statin were also no bargain (evidently, Costco was renegotiating terms with CapitalRx and they weren't an option when I looked). GoodRx and rivals like SingleCare didn't have such good deals on the statin, either.

But there was another cash-only pharmacy I hadn't tried before: RxForUs https://rxforus.com/ which is owned by an entity called Teleforhealth, Inc. which is based in the Los Angeles area and it says prescription fulfillment services are provided by Cedarmark Pharmacy located at 8737 Beverly Blvd #102 West Hollywood, CA 90048, and that company began in 2020. I only learned about it from a Facebook ad. One reason I was inclined to try RxForUs was because unlike other cash-based pharmacies (such as Blueberry Pharmacy, which charges $5 per month or $60 per year), RxForUs doesn't charge any membership fees. They have a similar model to Mark Cuban's Cost Plus Drug Company, in that they charge for shipping and a pharmacist filling fee. Unlike Mark Cuban Cost Plus Drug Company, however, RxForUs will tell you if they can get a prescription from multiple generic drug companies and what their prices for the drug are.

For a 90-day supply of rosuvastatin calcium 10 mg tablets, RxForUs says its "Best Negotiated Prices" were from NorthstarRx $6.67, Aurobindo Pharm $6.74, Torrent Pharma $6.54, or Biocon Pharma $6.58 — which were comparable to what I paid at Mark Cuban Cost Plus Drug Company. Add to that, Ground Shipping via USPS for $5, and a pharmacist fee of $3. While its good to know I have alternatives, and I'm savvy enough to know about them, but honestly, all of this nonsense is driving me kind of crazy. 

When will it stop? Why should I as a patient be forced to either overpay for cheap generic drugs, or find alternatives without the benefit of something like Google maps to help me navigate? 

Right now, I'm fine. But, it's starting to grow on my nerves!

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