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Pharmacies are flying solo and people are followingThe rising cost of prescriptions in the United States is no secret. This Pharma Bro showed just how easy it is to manipulate the price margins and make $$$$$ load.
Well, the actual pharma bros (pharmacists) and the business bros have taken the matter in their own hands. We are now seeing Cash Pharmacies (pharmacies that don't take insurance and dispense generic prescription drugs for a fraction of the cost).
Why should you care?
An average American takes 4 different medications. If you are one of these Americans who take regular prescription meds, You will never forget these letters: PBM.
PB... What? (Pharmacy benefit manager - AKA PBM). PBMs mostly control the cost of prescription medication, branded or generic. If you are a generally healthy person and have a good insurance prescription coverage, you may not care, but all of us have someone in our families who knows all about the PBMs and the price of prescription drugs.
Same meds, why different cost? A cost of the same medicine can vary based on where you buy it, which pharmacy has contracted with which PBM and about 100 more variables. When you need a medicine, you won't ask questions, just get the meds.
Cash pharmacies are making it super easy. With 100s of generic prescription medicines sold at a fraction of "insurance cost". Here is how Mark Cuban's pharmacy price their drugs. - They purchase the drug directly from the manufacturer (so no PBMs).
- They resell the drug with:
- 15% acquisition fee,
- $3 pharmacy labor fee,
- and a $5 shipping fee
- Tip: they also have "Price Drop Friday"
In 2019, 60% of Medicare part D spent was driven by 250 most commonly used drugs. The kicker is, these drugs were made by one manufacturer without a generic. According to a study in the Annals of Internal Medicine, Medicare could have saved billions if it had the power to purchase generic drugs. Well. The Inflation Reduction Act has changed that.
Things are going to be different starting 2026...
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- Vitamins: Most people take 2-3 vitamin supplements daily and to some extent these vitamins can proactively help with many serious illnesses, like COQ10. This online/in-store supplement store, run by an MD, only carries medical grade supplements.
- NeedyMeds is a non-for profit that can help with the cost of prescription drugs. They have partnered with many other organizations to help with the overall healthcare cost.
- Money left on the table: Most people don't realize that if they see a doctor and their insurance denies the claim as "out of network" doctor, the patients can submit an out-of-network claim for up to 12 months from the date of service. For $3.99 a claim, This company makes is super easy to file an out-of-network claim.
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- Pain in multiple body part: FDA has granted an approval to Abbot for a treatment that will the stimulate spinal cord to treat multi-site pain in the body. The device system is called Proclaim Plus.
- Speaking of spine, Taiwan received her first FDA clearance for a surgical robot for minimally invasive orthopedic surgeries. This robotic system is called POINT Kinguide.
- Inflation Reduction Act as the law (in 7 bullet points):
- As we mentioned above, Medicare could have saved billions if generic drugs (or similar competitive drugs) were purchased. With this act into law, Medicare Part B and D have the negotiation power for non generic or Biosimilr drugs. Eligibility starts in 2026 for 10 drugs and for 20 drugs in 2029.
- For 19 years, Medicare was banned from prescription price negotitation with the manufacturers. This law has put an end to that.
- Under Medicare Part D, this law has put a limit on the max spend of $35/month for insulin products.
- Starting 2024, no more 5% cost sharing for the catastrophic phase of Part D. Starting 2025, max out of pocket for Part D will be $2,000.
- Inflation cap in Part D, that will prevent prescription price hikes, year over year.
- Part D premiums cost growth cap at 6% from 2024 to 2029.
- The law extends premium subsidies in the ACA marketplaces to 2025.
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FEATURED PROVIDERS ON HBI |
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Advanced Medical Imaging Center (AMIC) is the largest and one of the oldest Imaging Centers in Chicago loop. AMIC has been providing quality radiological services since 1985. Our on-site board certified radiologists work closely with your physician to provide the best care possible, never compromising the quality of your imaging. We have two convenient locations, one in Chicago Downtown Loop and the other in Hyde Park neighborhood in Chicago, IL.
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Allergy & Asthma Center of Long Island (Great Neck, NY) is a best in class pediatric and adult allergy, asthma, and immunology specialty medical practice. Our board certified adult and pediatric immunologists offer highly specialized services from allergy testing, allergy treatments, asthma treatments, to immunotherapy. |
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Dr. Joshua Hong and the smile team care deeply that your dental experience is as comfortable and accommodating as possible. Your experience is important to us, and your confidence is in your smile. Come visit us and experience it for yourself. |
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Our Vision: Healthcare cost containment and price transparency
Health is one of the most precious possessions and the idea of health insurance is to protect this possession. Although, we have different personalities, our healthcare needs are quite similar. Yet, the cost of care varies significantly.
Health insurance deductibles, increasing out of pocket costs, limited coverage, pre-auth time restrictions and loss of coverage are SOME of the reasons, most people delay seeking care from a doctor, a dentist, a surgeon or a mental health specialist.
HBI believes that healthcare should be accessible with ease and cost transparency. New doctors, dentists, imaging centers and other healthcare specialties join us every single day.
Do a simple search and find a provider near you. |
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