Beth Joyner Waldron Profile picture
Dec 23, 2021 14 tweets 10 min read Read on X
1) Ok folks, buckle up.
I've been going through the financials of this CVS Caremark Eliquis issue because some things didn't quite square. We all know there is no clinical reason AT ALL to drop Eliquis, so it must be darn good business reason, right? But no.
Follow along...
2) Let's start with the drug #Eliquis In 2007, @pfizer and @bmsnews entered into a worldwide collaboration to develop & commercialize #Eliquis.

Third Quarter 2021 global earnings on Eliquis
= $1.3 BILLION Image
3)Most recent data I could find 2019--says around 3 million patients in US were taking Eliquis.

Fun fact @POTUSBiden takes Eliquis for afib, also has a history of DVT! Image
4) The generic for Eliqus (apixabn) WAS to have been available by now, but BMS has kept it tied up in patent litigation. Recent court ruling has pushed date for generic apixaban out to 2028. Image
5) Now let's look at @CVSHealth who owns @cvspharmacy (CVS Caremark) a pharmacy benefits manager. Despite news reports of retail store closings, the parent company had a pretty good 3rd Quarter also Image
6) Math is hard, but this is a pretty decent shareholders report I think @CVSHealth

Does that say total revenues INCREASED by how many BILLION? Image
7) Oh, but what about CVS Caremark, well the PBM line of business had a GREAT 3rd quarter too!!

Looky here folks, this says "Total revenues INCREASES 9.3% for the three months" ending 3Q 21.

Wow @AlanLotvinMD looks like @cvspharmacy is doing mighty swell. @elizcohencnn Image
8) So, let's recap our 2 corporations financials in this Eliquis drop decision.
@bmsnews posts BILLION $ profit for #Eliquis
@CVSHealth posts BILLION $ profit for its biz.
Yet neither can reach an agreement for patients to continue to get Eliquis, citing cost considerations.
9) That's what they are telling patients. This is the letter I got from @cvspharmacy. I've taken Eliquis for 8-9 years & now they say because they are "managing costs" and to ensure they are "used safely and appropriately" which is a laugh given the recent bleeding safety data. Image
10) If this is not about clinical evidence & it's not about managing costs (both making $$$) what the heck is the reason for taking away patients meds? It lacks reason on so many fronts. There's more to this story than is apparent. Full investigation needed. Protect patients.
11) I'd love nothing more than to go relax & bake Christmas cookies. But I can't. There's 150,000 patients who Jan 1 will be dangerously switched off their meds simply because they got caught between 2 corporations. This cannot happen! @AOC @elizcohencnn stoptheclot.org/news/urgent-pa…
12) I don't care who of you takes credit for fixing this @CVSHealth @cvspharmacy @AlanLotvinMD @bmsnews @pfizer but get together & GET ELIQUIS BACK ON FORUMULARY AT THE SAME TIER ASAP!!!!! Just do it! Our LIVES are depending on YOU to give us this Christmas miracle!
13) eliquis xarelo retail for about the same $. There is only cost savings moving patients from one drug to the other if @CVSHealth reached a deal with one company for preferred biz treatment. It's presented as if this is about cost, but it's really about a failed biz deal.
14) Sum: @CVSHealth #Eliquis drop was NOT a clinical decision. It was a strategic biz decision to pull patients into failed @bmsnews contract dispute, despite both corps being BILLIONS profitable & rising 3Q revenues. Patients worried at Christmas results may be deadly. Shameful. Image

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More from @BethWaldron

Feb 27
Congress is failing to address PBM reform without ever calling patients to testify.
The PBM execs have spoken.
The pharma execs have spoken.
Since apparently the only public platform patients have is social media, let me give an example how patients are being harmed.
🧵1/
Patients are caught between PBMs & pharma. Let's use as example a drug class so effective & popular they are the #1 (Eliquis) & #3 (Xarelto) federal drug expenditures. Even @JoeBiden & multiple members of Congress take them: anticoagulants aka 'blood thinners'. 2/ Image
Here's my last receipt for Eliquis.
Retail price = $ 713.33
Per recent Senate testimony, cost of production (1 month supply) = $ 1.50
Lifesaving. Used to treat/prevent blood clots such as DVT/PE & stroke caused by afib. Yet affordable only w/ good insurance coverage. 3/ Image
Read 16 tweets
Jan 12
🚨EXPOSED🚨
$CVS manager admits: “I don’t give a f*ck about this G-D job”.
PBMs determine WHICH drugs we can access, WHERE & their COST. Imagine being a patient forced to obtain critical medications only from this pharmacy.🧵1/
(Warning: video contains offensive language.)
For patients, the video's less-than-professional pharmacy environment simply reflects a final indignity faced when acquiring prescription drugs & vaccinations. There's often not the consumer freedom to go elsewhere. This MUST change as vertical corp integration rises. 2/ Image
Corporations like CVS Health have a fiduciary responsibility to shareholders, not to patients. They can per federal regulatory blessing steer patients to patronize other businesses they own & to formulary drugs w/ the highest profit margin they get kickbacks on from pharma. /3 Image
Read 11 tweets
Oct 23, 2023
A death due to PBM practices.

1 in 4 people die from clot related conditions. Anticoagulants treat/prevent. Yet insurer PBMs routinely put up barriers to these effective, life-saving drugs. Adverse events result. 🧵@linakhanFTC @BedoyaFTC @HELPCmteDems @GOPHELP @RebeccaDRobbins Image
Anticoagulants MUST be added to @HHSGov @CMSGov protected drug class! Given their importance to prevent clot & inherit risks in this medication class, namely bleeding, this MUST be done ASAP @BrooksLaSureCMS to protect patients. PBMs are unqualified to manage anticoagulation. Image
Additionally, these dangerous PBM tactics used to reduce patient access to effective clot preventing anticoagulants are well known & documented, but despite pleas we are still waiting for basic patient protections. Time for HHS, FTC & Congress to act! onlinelibrary.wiley.com/doi/10.1002/rt…
Read 5 tweets
Sep 12, 2023
New GAO report on drug rebates leaves no doubt that PBM formulary placement & utilization management decisions are NOT influenced by efficacy, safety, or medical need---as we've been told. Rather $$$
gao.gov/products/gao-2…
Image
"All plan sponsors and drug manufacturers had rebate agreements where manufacturers offered rebates for their drug based on the condition that competitor drugs be subject to restrictions in order to limit their utilization." Wow, think about how that motivates PBM decisions.
The #1 drug for adverse events, anticoagulant class= 17% rebates, 10% expenditures, 3% utilization. Are we really OK with a risky drug class's selection & management being determined not by clinical judgement alone but by non-transparent corporate financial considerations?
Read 4 tweets
May 10, 2023
.@SenTedBuddNC In today's @GOPHELP you asked PBMs about their rationale for how how formulary placement impacts patients ability to fill prescriptions from their doctors. You were told it was based on clinical evaluation. This is not true. I have the evidence to prove it. Image
I & 150,000 stable heart patients at risk for stroke & clot were forced off our long time medication by the largest PBM against our doctors wishes. 17 nonprofits said it was dangerous, largest cardiology nonprofit drafting clinical care guidelines met multiple times w/ the PBM. Image
It was only after 6 months of increasing news stories & social media of adverse events (strokes & bleeds) began getting shared more widely (some among your constituents in NC) that the PBM finally reversed their decision & added the drug back to national formulary. Image
Read 7 tweets
Oct 17, 2022
🚨🚨🚨 EXCLUSIVE AUDIO of senior CVS Caremark executives disparaging patients as "brand terrorists" who Tweet about poor PBM service accessing medications or score them low on satisfaction surveys.🧵1/
Audio is from a PBM Operations town hall event. Topic is a shift in methodology with the “Net Promotor Score” (NPS) which will allow CVS Caremark to minimize “detractors” to skew data towards being able to report more positive consumer satisfaction survey results. 2/
Survey design matters. $CVS Medicare Advantage product recently received a SIGNIFICANTLY LOWER govt rating driven by poor consumer survey results. CVS refuted the govt survey(by @CMSGov @AHRQNews) in SEC filing saying CVS's own internal surveys show higher + results. 3/
Read 22 tweets

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