The political pressure around PBMs has apparently given ESI's leadership a Paulian vision. The tone-deafness and clinical errors in their release belie their message of goodwill.
The 90 day supplies are a pet peeve of mine. When I ask for a 30 day supply, it's often because I'm testing something and am likely to stop / switch / change the dose after a few weeks. It wouldn't be so bad if the pharmacy took "no, I don't want to switch to 90 days" as an answer, but occasionally the automated systems don't sync and they just keep asking. Having to go through this process tempts me (usually I resist) to just prescribe 90 days to keep the pharmacies off my back, even knowing that 2/3 of it will go to waste and it will increase costs for everyone.
For what it’s worth, 1) this BS starts with insurers wanting to fulfill prescriptions via their wholly-owned mail order pharmacies 2) it’s also driven in part by Medicare through their use of the “quality metric” of “proportion of days covered” for Part D Plans. 3) in Utah, prescribing 30 days plus 11 refills or 90 days plus 3 refills is indistinguishable to the pharmacy- I can dispense up to 100 days provided I have refills available, and it’s not a controlled substance (I can’t increase the days supply on those).
The 90 day supplies are a pet peeve of mine. When I ask for a 30 day supply, it's often because I'm testing something and am likely to stop / switch / change the dose after a few weeks. It wouldn't be so bad if the pharmacy took "no, I don't want to switch to 90 days" as an answer, but occasionally the automated systems don't sync and they just keep asking. Having to go through this process tempts me (usually I resist) to just prescribe 90 days to keep the pharmacies off my back, even knowing that 2/3 of it will go to waste and it will increase costs for everyone.
For what it’s worth, 1) this BS starts with insurers wanting to fulfill prescriptions via their wholly-owned mail order pharmacies 2) it’s also driven in part by Medicare through their use of the “quality metric” of “proportion of days covered” for Part D Plans. 3) in Utah, prescribing 30 days plus 11 refills or 90 days plus 3 refills is indistinguishable to the pharmacy- I can dispense up to 100 days provided I have refills available, and it’s not a controlled substance (I can’t increase the days supply on those).
Ask Substack to add a LOL button.
Well said! Rhetoric change perhaps but unsubstantiated.