Bor Bor (@borbor513) profile picture
Brooklyn, NY
Joined October 2016
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.@A_Ciaccia explains how he teamed up with @mcuban and @costplusdrugs to compare what employers pay legacy PBMs against actual costs, and how @USDOL’s PBM Fee Disclosure final rule will empower employers nationwide to run the numbers: “We had data from employers across the country, and we simply just compared what those employers are being charged by their legacy PBMs compared to what @costplusdrugs can do... So you get all the data, and now you can compare it and start seeing... Now you’re going to be able to run it in any Excel sheet and compare and contrast how the employer’s experience compares to something else in the market.”
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Ask your PBM whether its pharmacy agreements price your claims one at a time, or against a discount measured across its whole book of business.
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Democrats rightly challenge weak FTC settlements with PBMs. No breakup of CVS or Express Scripts—even after FTC found $7.3B in revenue above estimated drug costs at Big 3 PBM pharmacies. @GovSherrillNJ @NJSenDems @njassemblydems @CmrChaNJ ncpa.org/newsroom/qam/2026/1…
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.@Sonderling47: “Since day one of his administration, @POTUS has taken bold action to bring down healthcare costs…the Trump Administration is ensuring that no one in the healthcare industry can escape the competition that comes from complete price transparency.”
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.@Sonderling47: “For years, previous administrations turned a blind eye as pharmacy middlemen built a fortress around their fees and compensation—but today, thanks to @POTUS, we ARE TEARING DOWN THAT FORTRESS—making the MOST SIGNIFICANT federal reforms for PBMs in decades. We know this rule will bring down healthcare costs for Workers and Job Creators.”
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White bagging: the PBM's specialty pharmacy ships an infused drug straight to the clinic for your member. It can cut the hospital's markup. It also moves the drug, and its margin, to a pharmacy the PBM may own. Ask who chose the channel and what each one costs.
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"The Trump administration will require the companies that manage hundreds of billions of dollars of drug spending to disclose details on how they get paid." wsj.com/health/healthcare/dr…
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Abolish PBMs ✊
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Independent pharmacies are facing retaliation from the Big 3 PBMs for supporting fair reimbursement for medicine costs and reasonable dispensing fees. A House investigation is underway to hold mega-corporate PBMs accountable.
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Last year OptumRx was awarded the ability to dispense the majority of medications in the NJSHBP. After they promised savings and consumed all the business costs went up anyway. What's wrong here? Public worker health care premiums face steep increases newjerseymonitor.com/2025/07…
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When PBMs like Optum RX, CVS Caremark, and Express Scripts claim that costs have been lowered, ask one simple question: Who benefits? PBMs profit from inflated drug prices through rebates tied to list prices, markups, and other arrangements, even when they negotiate lower acquisition costs. So who sees the benefit: the patient struggling to afford a prescription? The community at risk of losing its local pharmacy? The pharmacist working tirelessly to care for patients while facing unsustainable reimbursement rates? 🎯 👉👉Or the PBM and its shareholders, who benefits financially while everyone else bears the consequences? At the pharmacy counter, a patient arrives to pick up a medication they have taken for years, only to find out that the cost has increased substantially. Many have discovered that it's much cheaper to just pay the cash price, because their pharmacy benefit manager or PBM is requiring them to pay an inflated cost of the generic medication that the PBMs get discounts on. Meanwhile, the pharmacist is left explaining a system they do not control. PBMs can impose reimbursement rates so low that pharmacies struggle to cover the cost of purchasing and dispensing medications. Sometimes, filling a prescription can mean losing money, yet refusing to fill it could leave a patient without essential treatment. This creates moral injury, pharmacy closures, and many pharmacists just leaving the field all together. The patient faces an unaffordable prescription. The pharmacist faces an unsustainable business. The community risks losing access to its local pharmacy while the PBMs and shareholders profit. So when PBMs boast about lowering costs, we must ask whether those savings are actually reaching the people who need them. The truth is easily found in the number of patients who are skipping the use of it their own insurance and choose to pay cash instead. Lower costs for PBMs mean very little if patients still cannot afford their medications and independent pharmacies are forced to close. If PBMs push down the cost of medications but are mostly the only ones to benefit from inflated drug prices while patients struggle, pharmacists lose money, and communities lose access to care, who are these cost savings really serving? (Shareholders, executives, & PBMs.) 🚨The PBMs comments are also major deflection from the pharmacy benefit managers to not answer the question of why are they auditing independent pharmacists at higher rates after the pharmacists spoke up in support of legislation to put an end to the Monopoly power of PBMs. benefitspro.com/2026/10/26/a…
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All roads of bad intentions lead back to PBMs.
The House Committee on Oversight and Government Reform has launched an investigation into whether the BIG 3 megacorporate PBMs hit independent pharmacies with "punitive" audits in response to the push for PBM reform.
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A reader asked whether it is worth auditing a PBM if the guarantees all reconciled. Yes. A guarantee can reconcile on its own definitions and still miss money your plan was owed.
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Bor Bor retweeted
House Oversight Chairman James Comer is investigating whether PBMs retaliated against independent pharmacies that supported reform. The Pharmacists Fight Back Act passed committee 40-2 — and now the question is how far these companies will go to protect their power. Are PBMs targeting independent pharmacies? #PBMReform #IndependentPharmacies #HouseOversight #PBMRetaliation
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Bor Bor retweeted
With big PBMs, someone is always getting ripped off. Great article on why PBMs are afraid of @costplusdrugs healthcarerebelalliance.subs…
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Dear @Humana I will probably never understand how you can pay a pharmacy $537.44 for a box of Toujeo Max 300 unit/ml insulin for a Medicare patient, but yet REFUSE to cover the generic, which costs $165. Oh, and for reference sake, the brand name Toujeo Max wholesale cost is $560.00, so you can take your $537.44 “under-cost payment” and shove it straight up your ass. It seems the rebate incentives of your PBM are severely misaligned with reality. Make it right. Okay thanks, bye. ✌️
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