Beth Joyner Waldron Profile picture
Apr 12, 2022 10 tweets 9 min read Read on X
A man "working on behalf of the Office of The President" @CVSHealth called me outta the blue 2x last week wanting me to explain my TWEETS.

Listen as I'm told execs & @KarenSLynch herself review recordings & the 'case' they compile on me & other PBM Caremark insured patients.🧵
2) I do hope @KarenSLynch gets involved to get Eliquis back on Caremark national base formulary. As @FortuneMagazine 'Most Powerful Woman in Health Care' I haven't understood why her company couldn't negotiate a favorable deal with @bmsnews so patients have covered access.
3) Eliquis & Xarelto retail for about the same price.
My local Walgreens: Eliquis $617, Xarelto $620.Data below from @P4AD_ It's always a bit odd when 1 company raises their price within days of the other to match. 🤔 @bmsnews @JanssenUS Point is, note the retail costs.
4) Now note the rebate (kickback) to PBMs from pharma on these same drugs, average 66.5%. (source @SSRHealth @DrugChannels). As I've said, the ONLY reason Xarelto would be exclusively preferred over Eliquis on a formulary is due to a much higher rebate. No clinical reason.
4) When Caremark dropped Eliquis from formulary, 150,000 patients at high-risk for cardiovascular events already stable on it were forced off or had 2pay the full retail price. We don't get the rebate!! After 8 years on Eliquis switch to Xarelto, warfarin or pay $617mo my choice.
5) Yet for my condition Eliquis (apixaban) has been shown to have less recurrent clot & risk of major bleeding. I nearly died of a clot. My dad died of a bleed. I fear both. I advocate so care decision made between patients & their doctors based on clinical data are honored.
6) It's simply fact that Caremark decided to drop Eliquis from formulary for non-medical reasons. In doing so, they removed a top therapeutic for the prevention of stroke & DVT & that's why doctors, patients & 16 nonprofits are speaking out to get it back on formulary.
7) I won't rehash it all, but see this thread for the backstory on the Eliquis drop & Caremark's calls to me last week based ONLY on my TWEETS of a @FOX13Memphis story. I'm very concerned about the disregard of my medical record privacy.
8) @KarenSLynch by now you've reviewed 'my case', know patients are having stroke, bleeds simply because CVS got a better rebate from @JanssenUS than @bmsnews. What are YOU going to do about it to get Eliquis back on formulary for ALL patients nationally to prevent more harms?

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More from @BethWaldron

Feb 27, 2024
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, 2024
🚨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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