Caremark.....you saw it here (with CORE) five years ago

From John Curry, February 15, 2008
Subject: FLASHBACK...5 Years Ago -- CORE'S Nancy Hamant fought the good fight in court...today we have a small victory!

With today's headlines reading like these.....

CVS Caremark settles deceptive-practices complaint for $38.5 million (Chicago Tribune)

Settlement in Alleged Drug Company Kickback Scheme (XETV FOX6 San Diego, CA)

.....it is no small wonder how CORE's Nancy Hamant fought same the battle for transparency from a pharmacy benefits manager and lost because of a legal tenet known as "trade secrets." All of this was playing out on stage four years ago in a Franklin County Courtroom in Columbus, Ohio.

Well, the trade secrets still remain a secret but the company Nancy was after (Advance PCS- now owned by Caremark) parted with some of their pennies yesterday in an embarrassing out of court settlement involving the same kind of accusations that Warren County Retired Teachers Association set forth. Once again thank you, Nancy Hamant, from the bottom of our hearts. You were right "on the money" with this fiasco!

John and CORE members everywhere

Teachers’ pension drug administrator wants info private

Canton Repository, December 9, 2003
By PAUL E. KOSTYU
Copley Columbus Bureau chief

COLUMBUS — A public records request has landed the State Teachers Retirement System in court.

AdvancePCS Health sued the teachers pension fund to prevent release of information that the Alabama-based drug-benefit manager considers protected by state and federal trade-secrets law.

The company got a temporary restraining order Nov. 10 preventing the release of data about the rebates the company and pension system get from drug manufacturers. On Thursday, AdvancePCS and the pension fund will go before Franklin County Magistrate Tim McCarthy, who will determine whether to issue a permanent injunction to prevent release of the material.

Hoping to have a say in influencing McCarthy’s decision is Nancy B. Hamant of Pleasant Plain, and the Warren County Retired Teachers’ Association. They initially sought the rebate information from the state pension fund, and the fund was prepared to release it until the court stopped it.

AdvancePCS, which manages the prescription drug program for STRS, is one of the largest pharmacy benefits managers in the nation. It handles more than 500 million prescription orders a year for nearly half of the Americans with a prescription drug benefit.

Hamant said she wanted to do side-by-side comparisons of drug costs so she and other retirees can determine where they could get the best prices. No such comparison can be made, she said, if they don’t know how much STRS and AdvancePCS benefit from rebates.

She said they’re trying to save STRS money.

Pharmacy benefit managers act on behalf of employers, including state agencies, pension systems, insurance companies, unions and other health care payers, to get discounts by negotiating prices with drug companies.

A manager creates a list of drugs, called formularies, for which it provides full reimbursement. It then negotiates with pharmacies to set prices, can institute mandatory generic substitutions, and can negotiate volume purchase agreements with manufacturers.

Physicians prescribe drugs in part based on whether the drug is on the formulary. Thus, a pharmaceutical company has an incentive to be on the list, even if their drugs cost more than another brand or a generic version.

“Some of the formularies are more expensive than the brand drug,” Hamant said. “Some generic drugs are as much or more than the formulary. Some local pharmacies provide 90 days (of drugs) cheaper than the group rate.”

Getting the documents she wants is just half of Hamant’s problem. She’s concerned her position won’t be heard Thursday because she’s not a party to the suit. AdvancePCS sued the teachers’ retirement system, not Hamant or the Warren County Retired Teachers’ Association. Hamant has, however, without a lawyer, filed a memorandum in court opposing a permanent injunction.

Hamant said she’s not confident the pension fund will argue strongly to keep its records open, though it has been helpful in keeping her informed about the case. Hamant delayed a three-month trip to Texas, which was to begin Wednesday, so she can appear in court.

She said the Warren County retirees are at a disadvantage taking on a company as big as AdvancePCS.

“None of us have money for a lawyer,” she said. “We just wanted a simple list so we could see whether to use AdvancePCS or a local plan or go to Canada. We wanted to save (the STRS) plan money.”

Cynthia E. Hvizdos, a lawyer for STRS, said the retirement system assumed the material Hamant sought was public record.

“The burden is on PCS” to prove it isn’t, she said. “Our position is that the Warren County Retired Teachers Association asked for it and asserted a right to it. It’s up to a court to judge. We resolve any doubt in favor of public records.”

“If STRS is an agent for all its members, then why isn’t (the data) members’ information?” Hamant asked. “We’re the rightful owners of the information.

“If drugs costs aren’t controlled and health-care costs aren’t controlled, it’s going to bankrupt people and put them on welfare.”

Pamela N. Hultin, a Cleveland attorney representing AdvancePCS, said the argument is over one sheet of paper. The company, she said, released the other material sought.

“STRS has an agreement with AdvancePCS to keep the information confidential,” she said. “It’s financial information that is a trade secret. I’d like to have the secret formula of Coca-Cola, but I’m not going to get it.”

Hultin said the AdvancePCS contract with the teachers’ retirement system requires the pension system to notify the pharmacy benefits manager whenever someone requests or gets a court order for release of information pertaining to it. When Hamant filed her public records request, the system notified AdvancePCS.

AdvancePCS is in federal court in Alabama after two independent pharmacies accused it and three other top pharmacy benefit managers of “anti-competitive practices.”

That case said the companies used their status as middlemen to artificially fix prices and force “unconscionable” reimbursement rates on community pharmacies.

The suit alleges secret deals with drug manufacturers to push prescriptions on doctors and pharmacies in return for “kickbacks” and other “undisclosed incentives.”

Meanwhile, U.S. Sen. Byron Dorgan, D-North Dakota, has accused pharmacy benefit managers of refusing to tell congressional investigators how much money was being paid by drug companies to list drugs on formularies.

The Associated Press contributed to this story.

You can reach Copley Columbus Bureau chief Paul E. Kostyu at (614) 222-8901 or e-mail: paul.kostyu@cantonrep.com

Just remember...Providing health care to all Iraqis is sound policy, but providing health care to all Americans is socialism. PBM's and insurance companies have the best interests of the public at heart. Tongue in cheek! John