The wegovy pricing and legal struggles directly affects pharmacy and the
long term health of the profession. This is one of the more obvious and viewable examples of the twisted pricing schemes that are fueling
healthcare inflation and the Pharmacists are being squeezed and abused.
As a professional Pharmacist forum, we should discuss this article from
the WSJ and purhaps formulate a joint answer to it. The affect of PBMs
price fixing with the Pharmacy companies has pushed the cost of this
drug so high that it is breaking the buggets for healthcare third party providers and the PBMs are happily exploiting this to drive more
exclusivity contracts and more revenuses to their fat pockets. Fed up
with it, adminsitrators are just nixing the entire category despite
obvious life altering improvements that these drugs provide. There
complaint is that despite assurances of long term healthcare costs
savings, these saving never show up!!

It has taken them this long to figure out that all the healthcare
savings are being swallowed up by cost inflation. What they haven't
figured out is that the cost inflation is being driven by the PBMs and
their stangle hold on supply and prices.

So all they can think of doing to using this crisis to shunt all the prescriptions in Conticut, for example, to a single vendor. That is the
exact actions that have just fueled the problem and provides graft to politically connected vendors and does nothing to address the fact that
costs of drugs have become completely detached from affordable prices by
the public. In other words, the Supply and Demand curve has been
completely destoryed in the healthcare market and we have no real price points... just corrupt pricing schemes designed to generate as much
graft as possible for the PBMs.

the best thing that can happen is for all these drugs to go straight
cash. See how long the $1300/month price point have be maintained in a
really fair market.

https://www.wsj.com/articles/employers-cut-off-access-to-weight-loss-drugs-for-workers-cb277a44?page=1

As costs mount for popular drugs such as Wegovy, a cousin of Ozempic,
health plans are restricting coverage to save money

So many people have turned to drugs used for weight loss that some
employers are cutting off insurance coverage to head off climbing bills.

Spending on the popular drugs, which belong to the class including
Ozempic and can cost as much as $1,350 a month for a patient, has
quickly leapt into the tens of millions of dollars for insurance plans.
The outlays are straining the finances of some plans, including those
funded by employers.

After its costs for the drugs more than tripled over the past 18 months
to about $5 million a month, the University of Texas System said it
would end insurance coverage of Novo Nordisk’s Wegovy and Saxenda for
its employees and others covered by its health plans effective Sept. 1.

Continuing to pay for the medicines “is unsustainable due to the current
rate of prescription drug expenditures,” said a university benefits newsletter.

The reimbursement cuts, along with restrictions that other employers are implementing, mark the financial downside of the drugs’ medical triumph. While the medicines are the first to help people lose significant
weight, employers that must foot the bill may not be able to afford it.

“Everybody is concerned this treatment is going to add a huge cost
burden on health plans,” said Michael Thompson, chief executive of the National Alliance of Healthcare Purchaser Coalitions, which includes
groups representing employers. “It’s one of the key issues employers are having to wrestle with today because of the prevalence of these medicines.”

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