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Radar On Market Access: Pill Club, CVS Dispute Raises Larger Questions

Posted by Leslie Small on Sep 5, 2019

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CVS Health Corp.'s Caremark division came under fire recently when Pill Club, a birth-control-delivery startup, accused the PBM of restricting access to contraceptives amid a reimbursement dispute. The dustup even spilled onto social media, with the hashtags #CVSDeniesCare and #BoycottCVS trending on Twitter on Aug. 15.

While the dust has since settled, experts tell AIS Health that the incident raises bigger questions, including whether social media will increasingly be used by smaller fish in the pharmacy supply chain to amplify their negotiating clout with powerful PBMs.
 
The situation started when the PBM notified Pill Club and other non-traditional pharmacies that had been receiving reimbursements at the same rate as retail pharmacies that they would be subject to different terms, a CVS spokesperson told AIS Health.

Pill Club responded by calling out the company on a section of its website, which said that "CVS Caremark's proposed payment changes threaten Pill Club's ability to serve members." CVS, in turn, created a section on its own website to dispute Pill Club’s claims, writing that it is "irresponsible for The Pill Club to falsely suggest access to women’s health care is being jeopardized just so it can maximize its profits at the expense of our PBM clients."

Mariana Socal, M.D., assistant scientist at the Johns Hopkins Bloomberg School of Public Health's Department of Health Policy and Management, says Pill Club was "trying to harness the power from social media and public interest" in order to boost its negotiation capabilities with CVS. "I believe that that’s an important resource that we may see more and more being tapped into by perhaps these online retailers and others," she adds.


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Topics: Market Access, Provider, Payer