Latest news with #pharmacy
Globe and Mail
7 hours ago
- Business
- Globe and Mail
Ontario considers rule to limit exclusivity deals between insurers and pharmacies
The Ontario government is considering a new regulatory rule that would allow patients to access any pharmacy of their choice through a mandatory exemption – even if their private insurer has signed an exclusive agreement with a preferred pharmacy. The proposed rule is one of two options the Ontario government is seeking feedback on as part of its second public consultation looking at whether new regulations are needed to limit exclusivity deals between insurers and pharmacies, called preferred pharmacy (or provider) networks (PPNs). Insurers and some pharmacies argue the deals can lessen costs and guarantee certain service standards, while other pharmacies and patient advocates argue the agreements inappropriately constrain patient choice and could lead to poorer health outcomes. A second option the government is considering more closely is what it calls an 'any-able-and-willing-provider' (AAWP) model, which would require insurers to allow a wide range of health care providers into their networks. An 'any-willing-provider' measure would essentially end what are called 'closed' PPNs, in which patients can only get medication reimbursed if it comes from specific pharmacies that have deals with their insurance company. An 'open' PPN allows more pharmacies to join these networks if they can show they can meet certain quality and pricing standards. Ontario to launch new consultation on restricting exclusive deals between pharmacies and insurers During last year's initial consultation, the Ministry of Finance conducted 11 stakeholder roundtables and received 178 independent submissions. After reviewing the information, the government said it found that pharmacy PPNs 'may increase access' to specialty medications by 'enabling affordable coverage,' as well as 'significantly reduce' pharmacy mark-ups, from 15 per cent to 10 per cent, for example. The government also heard that, if employers and insurers are not able to utilize pharmacy PPNs to keep costs 'at bay,' employers may choose to reduce coverage or cut benefits altogether. When reviewing whether PPNs have any effects on competition, the ministry said it heard that they are 'not the only such arrangement' that may affect competition. Patient Support Programs, known as PSPs, are also arrangements where drug price and access are negotiated. The government also heard that vertical integration between insurers, pharmacy benefit managers and pharmacy operators may pose a risk to competition. The alternative option of introducing a standardized and mandatory exemption rule could also promote consumer choice, the government said, by limiting the circumstances in which a PPN may require or incentivize a patient to use a preferred pharmacy. Currently, PPNs may include a process for patients to request an exemption so they can access prescriptions at pharmacies outside of the network. However, these processes are not standardized across the industry and are at the insurer's discretion. Access to medication is increasingly being dictated by preferred pharmacy networks If introduced, an exemption rule would be standardized and mandated by statute, regulations and rules. Examples of a qualifying exemption would be medical, geographical or accessibility reasons. Karen Leiva, spokesperson for the Canadian Life and Health Insurance Association, said the association has long held the view that PPNs are an important tool for the industry. 'PPNs help to ensure that Canadians who need life-saving medication and other supports can receive them,' she said in an e-mail. Justin Bates, chief executive officer of the Ontario Pharmacists Association, said he is encouraged to see a form of 'any-willing-provider' legislation being explored as part of the second consultation. However, Mr. Bates also said that because this type of legislation would not be a blanket ban on PPNs, it could leave open the possibility that insurers create PPNs that are open in name only – because the terms of joining are so restrictive they exclude some pharmacies that find the requirements too onerous or expensive. The government's addition of the word 'able' to make the phrase 'any-able-and-willing-provider' has raised some eyebrows. Quinn Grundy, a professor at the University of Toronto who researches the pharmaceutical industry, said the use of the word 'able,' along with a mention of smaller pharmacies not necessarily having the right equipment to handle specialty drugs, was a red herring. 'I actually don't think that is the issue at all,' Prof. Grundy said. 'Everyone can get a fridge. These drugs are within any pharmacist's scope of practice to dispense. I think the question around able is whether they can afford to provide those services at the price that the insurer is willing to reimburse.' Mike Nashat, a pharmacist and director of OnPharm-United, a network of more than 600 independent pharmacies, said that competency standards should be set by regulators, not by parties to an agreement. 'We're increasingly concerned that the word 'able' will be used as a loophole to justify excluding qualified pharmacies from networks for commercial, not clinical or competency, reasons,' he said. PPNs do allow insurers to contain costs and ensure standards, said Chris Bonnett, a consultant on drug policy and private health insurance – but to work long-term, all parties must benefit. 'That means the terms have to ensure a viable market, be clear and transparent, and be monitored so that overall, everyone is better off,' he said. The Finance Minister's office declined to respond to questions about the consultation, which runs until July 28.
Medical News Today
14 hours ago
- Business
- Medical News Today
Namenda cost 2025: Savings tips and more
The cost of Namenda can vary based on several factors, including the form you take and your insurance coverage. Coupons and drug savings programs can also lower the price you'll pay for Namenda. As with all medications, the cost of Namenda can vary. Factors that may affect the price for Namenda you'll pay include: your treatment plan your insurance coverage the pharmacy you use whether Namenda has a savings program (see the 'Financial and insurance assistance' section) To find out what the cost of Namenda will be for you, talk with your doctor, pharmacist, or insurance provider. This section also has information about how much you can save by using an Optum Perks coupon. To save money on your Namenda prescription, explore these Optum Perks coupons. The active ingredient of Namenda is memantine. It's available as the generic drug memantine. A generic drug is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs. If your doctor has prescribed Namenda and you're interested in using memantine instead, talk with your doctor. They may have a preference for one version or the other. You'll also need to check with your insurance provider, as it may only cover one or the other. To find out how the cost of this generic drug compares with the cost of Namenda, talk with your doctor, pharmacist, or insurance provider. WHY ARE COSTS DIFFERENT FOR BRAND-NAME DRUGS VS. GENERIC DRUGS? Brand-name drugs can be expensive because of the research needed to test their safety and effectiveness. The manufacturer of a brand-name drug can sell it for up to 20 years. When the brand-name drug's patent expires, multiple manufacturers can create generic versions. This marketplace competition may lead to lower costs for generics. Also, because generics contain the same active ingredients as brand-name drugs, they don't require the same costly testing. If you take Namenda long term, you may be able to lower its cost in the following ways. You may be able to get a 90-day supply of Namenda. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you're interested in this option, check with your doctor, pharmacist, or insurance provider. Namenda may be available through a mail-order pharmacy. Using this type of service may help lower the drug's cost and allow you to receive your medication without leaving home. Some Medicare plans may help cover the cost of mail-order medications. You may also be able to get a 90-day supply of the drug via mail order. If you don't have health insurance, talk with your doctor or pharmacist. They may be able to suggest online pharmacy options that could work for you. You may want to consider the following information if you have insurance and receive Namenda. If you have insurance, your insurance company may require prior authorization before it covers Namenda. This means the company and your doctor will discuss Namenda in regard to your treatment. The insurance company will then determine whether the medication is covered. If a drug requires prior authorization but you start treatment without the prior approval, you could pay the full cost of the medication. You can ask your insurance company whether Namenda requires prior authorization. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses. Alzheimer's / Dementia Pharmacy / Pharmacist Drugs
Fast Company
19 hours ago
- Business
- Fast Company
Walgreens buyout could change the future of pharmacy care
Pharmacies are more than just stores. They're vital links between people and their healthcare. One of us, Patrick, witnessed this firsthand in 2003 while working as a pharmacy technician at Walgreens in a midsize West Texas town. Each day involved handling hundreds of prescriptions as they moved through the system—meticulously counting pills, deciphering doctors' handwriting, and sorting out confusing insurance issues. The experience revealed that how pharmacies are owned and managed is as much a public health issue as it is a financial one. Fast-forward to today, and Walgreens—one of the world's largest pharmacy chains, which filled nearly 800 million U.S. prescriptions in 2024 —is at a turning point. In March, the company announced it would be acquired by private equity firm Sycamore Partners for $10 billion, just 10% of its peak market value. That deal takes the storied pharmacy chain off the public market for the first time in nearly 100 years. We're professors who study the intersection of medicine and business, and we think this deal offers a window into the future of pharmacy care. It matters not just to pharmacists but also to the tens of millions of Americans who rely on outlets like Walgreens to meet their everyday health needs. The rise and struggles of Walgreens A lot has changed in the pharmacy industry since 1901, when Charles R. Walgreen Sr. purchased the Chicago drugstore where he served as a pharmacist. The company went public in 1927, expanded rapidly throughout the 20th century and grew to 8,000 stores by 2013. By 2014, a merger with the European pharmacy chain Alliance Boots made Walgreens one of the largest pharmacy chains in the world. More recently, however, the picture for the pharmacy industry hasn't been so rosy. Labor costs have risen. Front-end retail sales (things like snacks, greeting cards, and cosmetics) have fallen. And financial pressures from pharmacy benefit managers —those third-party groups that manage the cost of prescription drug benefits on the behalf of insurers—have grown. All of these things have significantly constrained revenues across the industry, leading stores to shutter. Some estimates suggest that as many as one-third of U.S. retail pharmacies have closed since 2010. Against that backdrop, Sycamore Partners' March acquisition of Walgreens raises big questions. What does Sycamore see in this investment, and what might their strategies imply about the future of American pharmacy care? Framing the private equity bet Private equity firms typically buy companies, streamline their operations, and seek to sell them for a profit within five to seven years of the acquisition. This growing movement of private equity into the global economy is by no means limited to healthcare. In 2020, private equity firms employed 11.7 million U.S. workers, or about 7% of the country's total workforce. The total assets under management by such investors have grown by over 11% annually over the past two decades, a trend that's expected to continue. In looking at Walgreens, Sycamore, like many of these businesses, likely sees an opportunity to buy low, cut costs and improve profitability. One survey of private equity investors found that the most common self-reported sources of value creation in these deals for companies of Sycamore's size were changing the product and marketing it more robustly to drive demand, changing incentives for those within the business, and facilitating a high-value exit. While private owners may have more patience than public markets, critics argue that private equity firms tend to have a short-term focus, looking for quick, predictable services of margin improvement—like, for example, cutting jobs. There's some evidence in favor of that claim. One study found that employment often drops in the years following a private equity buyout. And if the focus shifts to repaying debt or prepping for resale, long-term projects, such as investing in future innovation, can get deprioritized. The history of privatized public companies offers a mix of successes and failures. Dell Technologies and hotel chain Hilton are two prominent examples of companies that went private, restructured successfully, and came back stronger. In those cases, going private helped management focus without the constant pressure of quarterly earnings reports. On the other hand, companies such as Toys R Us, which was taken private in 2005 and filed for bankruptcy in 2018, show how high debt and missed innovation can lead to collapse. What's next for Walgreens If part of the returns will be driven by 'buying low' (the easiest indicator of potential future success to measure as of today) Sycamore started well: Its purchase price represents a mere 8% premium over the market trading value on the day of the announcement, significantly less than the 46% seen across industries in 2023. That said, Sycamore financed 83.4% of the purchase with debt, a number on the high end for these kinds of transactions. Healthcare groups have pointed to this number while raising concerns that innovation-focused investments may take a back seat to debt obligations. As the dust settles on the purchase, Sycamore has indicated an interest in splitting Walgreens into three business units: one focused on U.S. pharmacies, one on U.K. pharmacies, and one on U.S. primary healthcare through its VillageMD subsidiary. That's not unusual: Sycamore has used a similar approach before with its investment in the office supply retailer Staples, a strategy that has garnered strong financial returns but been called into question for its long-term sustainability. Given the significant financial challenges VillageMD has faced since its acquisition by Walgreens, this represents an opportunity to separately evaluate and optimize its performance. Meanwhile, Sycamore's historic focus on retail and customer-focused businesses might help it modernize the in-store experience or optimize staffing. For more than a century, Walgreens has survived and adapted to sweeping changes in retail. Now, it's entering a new chapter—one that could reshape not just its own future but the role of pharmacies in American life. Will Sycamore help Walgreens thrive, using its resources to strengthen services and deliver more value to customers? Or will pressure to generate quick returns create problems? Either way, the answer matters—not just for investors but for anyone who's ever relied on their neighborhood pharmacy to stay healthy.
Yahoo
20 hours ago
- Business
- Yahoo
1 Large-Cap Stock with Exciting Potential and 2 to Think Twice About
Large-cap stocks are known for their staying power and ability to weather market storms better than smaller competitors. However, their sheer size makes it more challenging to maintain high growth rates as they've already captured significant portions of their markets. These trade-offs can cause headaches for even the most seasoned professionals, which is why we started StockStory - to help you find high-quality companies that can grow their earnings no matter what. Keeping that in mind, here is one large-cap stock with attractive long-term potential and two whose momentum may slow. Market Cap: $79.42 billion With over 9,000 retail pharmacy locations serving as neighborhood health destinations across America, CVS Health (NYSE:CVS) operates retail pharmacies, provides pharmacy benefit management services, and offers health insurance through its Aetna subsidiary. Why Does CVS Give Us Pause? Scale is a double-edged sword because it limits the company's growth potential compared to its smaller competitors, as reflected in its below-average annual revenue increases of 7% for the last two years Estimated sales growth of 2.5% for the next 12 months implies demand will slow from its two-year trend Earnings per share fell by 2.9% annually over the last five years while its revenue grew, showing its incremental sales were much less profitable At $62.78 per share, CVS Health trades at 10.2x forward P/E. Read our free research report to see why you should think twice about including CVS in your portfolio, it's free. Market Cap: $33.52 billion With over 2,500 research experts guiding organizations through complex technology landscapes, Gartner (NYSE:IT) provides research, advisory services, and conferences that help executives make better decisions about technology and other business priorities. Why Are We Hesitant About IT? Earnings growth over the last two years fell short of the peer group average as its EPS only increased by 9.3% annually Gartner's stock price of $435.88 implies a valuation ratio of 35.1x forward P/E. If you're considering IT for your portfolio, see our FREE research report to learn more. Market Cap: $61.71 billion Aiming to be a one-stop shop for the DIY customer, AutoZone (NYSE:AZO) is an auto parts and accessories retailer that sells everything from car batteries to windshield wiper fluid to brake pads. Why Will AZO Beat the Market? Store expansion strategy is justified by its healthy same-store sales Unique assortment of products and pricing power result in a best-in-class gross margin of 51.8% Robust free cash flow margin of 10.6% gives it many options for capital deployment AutoZone is trading at $3,700 per share, or 22.3x forward P/E. Is now the right time to buy? See for yourself in our comprehensive research report, it's free. Donald Trump's victory in the 2024 U.S. Presidential Election sent major indices to all-time highs, but stocks have retraced as investors debate the health of the economy and the potential impact of tariffs. While this leaves much uncertainty around 2025, a few companies are poised for long-term gains regardless of the political or macroeconomic climate, like our Top 9 Market-Beating Stocks. This is a curated list of our High Quality stocks that have generated a market-beating return of 183% over the last five years (as of March 31st 2025). Stocks that made our list in 2020 include now familiar names such as Nvidia (+1,545% between March 2020 and March 2025) as well as under-the-radar businesses like the once-micro-cap company Kadant (+351% five-year return). Find your next big winner with StockStory today for free. Sign in to access your portfolio
Daily Mail
a day ago
- Business
- Daily Mail
CVS to shutter 270 stores this year
Published: | Updated: The pharmacy retail industry is struggling. CVS, the chain with over 9,000 locations across the US, confirmed to that 270 locations would shutter this year. The closures, which the company initially announced in October 2024, have been underway in several states, with Alabama , New York, Maryland , and Missouri seeing the largest amount of closures. But it also opened over 100 new locations, including 30 inside of Target locations. 'We're focused on ensuring we have the right kinds of stores and the right number of stores in the right locations,' a CVS spokesperson told 'Even after the realignment work, 85 percent of people in the US will still live within 10 miles of a CVS Pharmacy,' the spokesperson added. Pictured: David Joyner, executive vice president and president of pharmacy services at CVS Health Corp. 'And, while we're closing certain locations, we're also opening stores and pharmacies in areas where there's a need,' the spokesperson added. The changes come as pharmacy retailers face severe headwinds against their critical businesses. Upstart online brands — like Capsule and Blink Health — are attempting to eat into brick-and-mortar sales with more convenient delivery models. Even Amazon entered the pharmaceutical space, launching its medication delivery platform in 2020 . 'Luckily I don't depend only on CVS,' one Redditor said about the company's decision to shutter stores while facing the increasing competition. Meanwhile, front-store retail sales, where customers grabbed toothpaste and Tylenol while raking in millions for pharmacies, have cooled. Shoppers have largely turned to lower-priced retailers while the US economy struggles with sticky inflation after the 2020 pandemic, retail experts have told These challenges have sent CVS competitors into tailspins. Several brands have launched mass closure events or declared bankruptcy. Walgreens has been pressing ahead with plans to shutter hundreds of stores. The pharmacy brand pledged to shutter 1,200 locations by 2027. The company, struggling to compete with lower-cost models and lampooned by billions of dollars of debt from opioid settlements, said it would shutter all of its locations. 'This is going to cause a pharmacy desert in my neighborhood and prescription nightmare,' one worried customer wrote on Reddit. CVS has stepped in, purchasing pharmacy locations from Rite Aid. They're expected to take on the most customers, having bid on the prescription files of 625 Rite Aid pharmacies across fifteen states.
