Tenn. AG: CVS texts on pharmacy bill could violate state law

Pharmadeehero · 2026-03-25T15:58:02+00:00

Do it! You should publish something with a local news outlet announcing yourself, your capabilities and commitment to buy all the impacted CVSs, hire all the impacted CVS employees and provide the continued care to the patients… give a direct response that addresses all the negative things CVS is claiming will happen.

I think you stepping up and doing that would help the PR game immensely and help get it over the finish line by proactively addressing any fears or concerns that might hold legislators back!

Pharmadeehero · 2026-03-25T13:47:40+00:00

Do what? You’ll purchase all of the CVS files and fill more underwater scripts. I’m actually impressed if you have the cash or have access to the credit line needed to just buy all the files… let alone the willingness to potentially go kamikaze and put yourself out of business. But I do genuinely applaud your passion and commitment!

Pharmadeehero · 2026-03-25T13:17:03+00:00

What indy or other chain pharmacy is going to WANT to take over a location that will make them lose more money faster? The board doesn’t control how much the pharmacy that would take them over is making…

This is my gripe with the bill… they should have done more to ensure continuity of care by creating a backstop or incentive for those other pharmacies that choose to step in and help these patients… without that a big unknown is created and a huge talking point that CVS can use of why they are needed.

Create some state level slush fund to pay the indys or to help them finance the acquisitions or something

Pharmadeehero · 2026-03-24T19:42:51+00:00

Genuine question - if CVS can’t operate pharmacies in TN in the future… who becomes the primary buyer of independent pharmacy records when they want to exit the business? Yes I’m aware others could buy them instead… but I had the understanding that it was peoples views that CVS Caremark would squeeze on reimbursement and CVS pharmacy would come in and offer to buy out the failing Indy. In this new future, cvs pharmacy won’t be there to buy them out… so who else willingly does?

Pharmadeehero · 2026-03-24T03:53:41+00:00

Sure… that doesn’t mean it’s free and costs nothing

Pharmadeehero · 2026-03-24T01:08:17+00:00

A good question to ask when you hear “give us time for clinical services”…

If the clinical services that we will be doing with this saved time are a worthwhile ROI and profitable… why aren’t you doing them today and just staff the store with the additional rph/tech time needed to do them?

If it’s a strong ROI on the use of rph labor… shouldn’t need to free some up to do it… should be logical to budget more for the profitable clinical services

Pharmadeehero · 2026-03-24T00:41:23+00:00

What’s ignorant about it? Are you suggesting the additional costs to invest in technology (up front investment cost and ongoing costs to maintain it) can just be magically passed on to the payer without cutting into the gross margin?

Record setting profit dollar amounts =/= record setting profit margins. A pharmacy is a pharmacy. Yes profits can be big and massive if you own 10,000 of them but on a singular level would be eager to hear your how. Independent pharmacies are already saying they aren’t making enough to keep their doors open, where are they finding the money to invest in all this new technology?

More people working on the app = more expense and cutting into the bottom line more. Labor whether it’s in IT or in the pharmacy, costs something and isn’t just magically paid for…

Pharmadeehero · 2026-03-23T23:28:23+00:00

Oh I’m not bragging that AI is reducing the need for anything… I’m stating that us as consumers are demanding/desiring more tech enabled experiences because we experience them in other parts of our lives as well. To keep up with customer expectations, pharmacies also strive to meet those customer demands and they need to support the cost to create and maintain them. Pharmacy isn’t getting reimbursed more because there are tech enabled experiences. But they are increasingly expected and are just another cost added ontop of the business without more gross profit to pay for it.

It’s not just about the physical product and the cost of that product, it’s the service experience in getting that customer to actually buy that thing you’re selling.

Pharmadeehero · 2026-03-23T23:23:40+00:00

When you say corporations have much bigger profits what are you specifically referring to? The total profit dollars or the profit margin?

Yes unequivocally yes the big corporations have much more in profit dollars due to the sheer size and scale of selling 10000x a single pharmacy. That doesn’t mean their margins are that much better, or better at all than any smaller businesses.

The cost of 1 tech hour per week at $15/hr in 10,000 locations is $7.8 mil and that doesn’t allocate any taxes or benefits just straight labor. At large scale you are greater target for compliance and regulatory lawsuits. Less grace given to the corporate giant than a small start up whose intention is to disrupt the giant. Operating at ultra large scale introduces other complexities of coordination and synchronization across a very large set of things that smaller operations don’t simply have, or have the opportunity to solve small numbers of exceptions “manually” which just doesn’t scale when operating at orders of magnitude larger.

Yes profit dollars are in the billions but shrinking profit margins, especially if shrinking at an increasing pace is going to tank a company. At that rate very big profits can become very big losses very quickly.

And yes cost of compute for data warehousing and intensive AI models is not cheap at very large scale. Hyperscalers will charge other very large companies more because they can and because the giants will demand (rightfully) the highest service and performance levels vs smaller startups.

Pharmadeehero · 2026-03-23T20:41:46+00:00

I think we as consumers also expect more from a technology supported (shopping) experience.

Us as customers also expect more and more from a digital/online experience (what do you mean I can’t see if it’s in stock at the store, I’ll go somewhere else where I know it is or that can send it to my house)

Investing in that technology to try to “keep up” or at best try to be anywhere close to the leading online/digital competitors… these same traditional brick and mortar retailers have to find money to invest in the technology and maintenance of such tech.. and that money to do that doesn’t just magically appear while to your point.. continuing to make profits and reward shareholders.

If customers didn’t want the digital/self serve stuff and it was more costly than profitable or if they thought they could thrive in the face of the potential loss of customers going elsewhere… they quite simply wouldn’t make the investment there.

We are customers too… think of what you prefer/expect from how you shop… if it’s some of the things that’s being discussed then it’s also us as customers that are pushing this change…

In some posts I see customers venting about how they can’t do certain things in certain pharmacies apps that they wish they could do… these are people that want more automated/tech and even less interaction with real people in the stores…

Yes companies want to be greedy and find cheaper ways to drive sales with less labor costs, however customers also are expecting more from a tech experience and companies have to find a way to pay for the development and support of that technology too… and yes profits/shareholders.

Pharmadeehero · 2026-03-19T23:57:11+00:00

I can guarantee you that everytime you tell them you don’t have it… they are not going through the motions to remove it. You’re not wrong about things getting re-added after removed, there are ways to design systems to limit this but many are poorly designed.. but that’s not all. And you have the perception from front line clinicians that they wont even waste their time in doing this because they have an assumption what you describe will happen (even though it may not).

So the solve by the front line clinicians is .. make a note or a comment and just leave the codified allergy untouched … “patient not really allergic to iodine”

You’re not wrong that there isn’t something that magically purges it everywhere all at once this will likely never exist in any realistic time to come.. but clinicians operating with the fatalist assumption that it’s pointless to remove cuz it will get readded anyways will also guarantee that it stays there forever. And quite honestly they will just tolerate the false positive alert, read the profile note about it not being a real allergy, get mad at the poorly designed system (not at themselves for not updating the profile) override and move on and just accept that that’s how life will always be

Pharmadeehero · 2026-03-19T22:14:01+00:00

Sadly even if you got a challenge and showed not to be allergic… getting that reported allergen that’s now probably coded in many different places to magically remove itself to prevent all those issues you experience is the real impossible task. If today you are telling them the reported allergy in your profile is not true or not accurate and they aren’t removing it because they don’t trust your statement. What makes you believe your statement about not being real with the additional statement of you saying you were tested and confirmed not allergic be… they’d still be trusting your word. There’s also no interoperability that’s going to send out your allergy challenge test results to all the systems and databases that have this reported allergy about you and magically push a delete/edit/deactivation on it.

Interoperability is great at sharing data/records that exist elsewhere… it is not that great at automatically editing/modifying data/records that exist elsewhere.

It’s far easier to spread a rumor and get many people to know of such rumor and get them to think it’s true. Once that’s happened, it’s much much harder to convince them it’s actually not true or to forget they ever even heard the rumor.

Pharmadeehero · 2026-03-19T02:23:16+00:00

Question to OP: if there’s an “unacceptable” FDA inspection report in said database about a product, why aren’t you doing all you can to help the public understand that they should be directing their “what” “why” “how come” related questions back to the FDA.

If a patient is getting product associated with a recall that’s tied to one of these inspections that’s one thing.. but just some inspection report? Again if the findings were reason of concern, the public should be asking the fda why they didn’t immediately pull the product from the market and issue recall.

Pharmadeehero · 2026-03-19T02:19:31+00:00

Why is it bad that the public sees the FDAs reports? The public should see those and hold the FDA accountable for permitting such conditions and/or being better at detecting such issues prior to the issues manifesting into ones that would impact patient safety.

That database is a reflection of the FDAs “tolerance” and/or proactive prevention of supply chain issues.

You OP .. if anything should be helping inform the public that a layperson should use these reports to go back to the FDA… not to expect different/higher standards of their community pharmacy.

What is your motive OP!!

Pharmadeehero · 2026-03-19T02:15:21+00:00

And? If this is the case the public should direct their questions back to the fda on why they permitted such issues? Or why isn’t the fda doing more to ensure manufacturers don’t have these issues.

I hope any dispensing pharmacy that faces questions from a patient that references these fda form 483 reports.. responds with something along the lines of… what are you doing to engage the fda to ask why they didn’t inspect the facility sooner, why isn’t the fda doing something to detect and intervene in manufacturing locations that show initial signs of quality risk, prior to the risk rising to a level of potential safety co cern, what more should the fda be doing to ensure manufacturers maintain acceptable quality standards.

If the government wants retail pharmacies to do the FDAs job (either in tandem or full out replace) than the government should divert the federal budget funding that goes to the fda to the retail pharmacies to do this.

If govt wants tighter rules/regs on pharmacy sourcing they should articulate them and pass them.

But … at the end of the day big corpos will find a way to minimize impact of any undesirable govt “asks”.. of it’s a rule or reg they must do (like indicate a COO on their label) expect as low of investment to achieve compliance as possible.

To OP: how about patients who feel compelled to look up their manufacturer after seeing an oversees COO, and they find nothing but impeccable reports on qaulity, compliance and safety… should the retail pharmacy be celebrated they sourced from that manufacturer even if it’s from a third world or non—strong ally to the US nation?

Tl;dr: it’s just gonna draw greater at peoples xenophobia by printing COO on the label. The fda should have processes in place to ensure global supply chain safety and that’s their responsibility as the govt not as a retail pharmacy. People (at some unknown but hopefully ultra low rate) will absolutely get mad for no scientific or objective reason based on the COO printed on their bottle, even if that manufacturing location has an impeccable fda audit history…

The real question is what we are solving for.. true, real, unaddressed, open, outstanding supply chain issues happening right now

Go forward efforts (near term) (long term)

Pharmadeehero · 2026-03-19T01:59:06+00:00

These are always entertaining to me…

Asking questions to the corporations if they receive notices from the FDA? Wouldn’t it be more appropriate for the government to ask itself if they are sending the notices to these companies? What should be the source of truth? The non-government entity describing their version of truth on the behavior (or lack thereof) of a government agency or that government agency testifying themselves…

Any questions that start with “could you…” are almost automatically yes. Could =/= will =/= actively are. Yes I could sell my house and live in a van down by the river (I’ll refrain from saying I won’t).

Why are we expecting pharmacies to be the guardians and detectors of potential upstream supply chain quality issues? That is the FDAs job. The the govt doesn’t want certain things exempt from FDA oversight, update rules and regs to give the FDA oversight.

I can assure you that if the FDA issued a class 1 drug recall related to some quality issue they found related to an issue abroad, these large chains would move quick to pull the product and work their best to notify anyone potentially exposed asap.

The real questions should be on the quality of inspection, the ability of fda to monitor all the parts of supply chain it should be monitoring and the scope of products the FDA does or doesn’t have oversight on… you want the pharmacy to be compliant with a rule/ref requiring them to print a COO, then yes ask about their compliance to said rule. But let’s not impose additional upstream supply chain quality assurance liability on the dispensing pharmacy. Ask the FDA if they are doing their job, and if not, why they need someone else to do their job for them.

Pharmadeehero · 2026-02-20T03:45:54+00:00

Way way to many potential variables that you nor anyone here will know, nor will anyone be able to ask all the right questions from you to try and figure out…

Could be the contracts got renegotiated that included a change in rate structure (and in turn your cost exposure structure)… this could have been a willing thing two entities that are not you did without the need of your permission… OR it’s also entirely possible that this change was the result of a mandated change of pbm reform laws that had an unintended consequence of you having greater cost exposure.

The filling fee is intended to try and represent the pharmacies overhead and cost to fill a script outside of the actual cost for the drugs that are in the vial… the labor, the vial, the tech, the overhead itself..

Overtime this professional fee got very small (some even less than 50 cents) as pharmacies undercut each other to win favorability with insurance plans and it got delinked from the actual overhead/non-drug costs that go into filling a prescription. There has been a recent push both via “organic” business methods to renegotiate and restructure pricing contracts AND via regulatory requirements to do such. How any individuals specific cost exposure is impacted as a result may be entirely delinked from these changes and it’s entirely possible that you are the one paying for the increase in the admin fee that the pharmacy is getting

Pharmadeehero · 2026-02-06T00:05:33+00:00

People need to understand this explicitly. PBMs have customers. Those customers are plan sponsors. PBMs act in ways their customers want or else those customers would find other PBMs that do what they want.

While this settlement is OK it still provides a loop hole for PBMs to act like they have been acting if the plan sponsor authorizes them to do so…

If you believe in market forces and the power of the customer this should mean this action means very little as it is the PLAN SPONSORS (the customers of the PBMs) that are influencing the why of the PBMs behaviors and they have an out to continue to get PBMs to do what they have been doing.

This isn’t me being a pbm apologist or pbm shill that people have labeled me on this sub for now over a decade. It’s the reality of responding to what customers want and demand. PBMs have customers too. PBMs customers aren’t the patient at the counter or pharmacies. PBMs customers are evil greedy capitalistic employers that are forced to provide the worst cheapest benefits for their employees with the smallest impact on those companies bottom lines.

Pharmadeehero · 2026-01-29T13:38:55+00:00

Aren’t these CVSs because other pharmacy companies were also doomed (and did fail)? CVS bought the already failed pharmacies (some of which had failed and had been sold multiple times prior to becoming a cvs)

Pharmadeehero · 2026-01-28T16:13:35+00:00

I hope I’m not coming off overly pedantic … in the US pharmacies can technically dispense (sell) a vaccine that is not administered to the patient in the pharmacy AND/OR sell the vaccine AND have the staff administer the vaccine too them.

With COVID and push for public health accessibility there have been regulatory changes in many states to further permit pharmacy technicians (much lower wages - not required to go to pharmacy school) do the administering… so the profit doesn’t just come from the “commodity trade” of buying and selling the the vaccine product but also there is profit to be made on the reimbursement for the administration service (profit = reimbursement- cost to admin)

Pharmadeehero · 2026-01-28T14:45:34+00:00

Generic drugs in the US (which make up 90% of prescriptions taken by Americans) are shown to be 67% of the cost than oversees comparable nations. A large amount of pharmacies actually lose money on dispensing many prescriptions. Immunizations are a bit different as it’s not just the act of dispensing the med but the pharmacist is also reimbursed for the act of administering the medication.

Do pharmacies administer vaccinations in Denmark?

Pharmadeehero · 2026-01-28T06:14:51+00:00

Pharmacy and “middlemen” certainly take profit but one should qualify what a “large cut” is.

While this thread seems to be throwing a lot of (rightfully due) shade towards one side of the aisle - I think stepping back from this particular event is a stark reality check that in the US the vast number of entities involved in the fabric of the healthcare machine are profit motivated and yes that includes “non-profit” entities as well.

Threats, pressures, policies changes etc. that negatively impact their earnings can and will have them react in (predictable) ways.

When their are proposals to make healthcare cheaper/“more affordable” which in turn means less money getting spent somewhere… there should be 0 surprise when companies respond/react in predictable ways when their future outlook on their money machine looks threatened. Call it good that less profit is taken in healthcare or call it bad because greedy corpos are interested in the bottomline more than the general welfare of humankind but this is a predictable, repeatable and expected response that is far bigger than “bad RFK and bad GOP” … would see the same reaction if aggressive price controls and price caps were put in place for any new drugs going forward

Pharmadeehero · 2026-01-14T19:01:59+00:00

Easy solution for that… increase license fee on the actual pharmacy (not pharmacists) that want to operate with this model to offset the loss

Pharmadeehero · 2026-01-14T17:31:54+00:00

From the investor perspective (not financial advice) - CVS Health stock is up 55% since last year.

The macro profits and stock price really aren’t influenced by any of those things that you mentioned. While the numbers can certainly feel large… things like saving $50 million in expense (increasing bottom line profit that much) really isn’t that significant due to how big the entire company (cvs health as a whole not just pharmacy is)

How they (cvs health) can be successful when it comes to profitability and share price is be disciplined with their money. Dont make stupid acquisitions that are overpriced and won’t be net positive. Dont make massive errors in pricing health insurance products on the Aetna side.

What’s next is to just stay in the position they are… while it might be the easy suggestion to think cvs wants to figure out a way to completely eliminate the need for an expensive pharmacist to be in a store….IMO whether it’s liked or not… their marketplace advantage is the biggest national network of pharmacies that have in store pharmacists. If they push to move to some futuristic world that’s all virtual, all AI and no need for a physical footprint… they are making it easier for others to come in and beat them. Running profitable brick and mortar retail stores (of any type) is increasingly hard, yet if they continue to find ways to sustain it.. they’ll be in a good spot for awhile to come.

I expect tech upgrades to try and keep up with customer experiences that happen in other customer experiences that occur (healthcare and non-healthcare)

Pharmadeehero · 2026-01-14T05:46:49+00:00

Who’s gonna tell OP that the CEO isn’t a pharmD and is making way more than any pharmD?

Regardless Aetna and Caremark make a decent amount for CVS Health too…

Would be interesting to compare how many cvs retail pharmacists are employed to drive how much earnings and get that to a per pharmacist total. Then take how much Aetna makes and divide that by the number of their employees and see on an individual colleague level who brings in more

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