Pharmacy owners are no stranger to crazy, outlandish stories from insurance companies and their representatives. That is why the story I am about to share most likely will not come as a shocker to any of you who read this.

I was in meeting with a large insurance company in my state this week. When they were reviewing the benefits of their new policies, I noticed there was a significant amount of love for CVS and Caremark. I just so happened to know that Caremark is the PBM this insurance company uses for their prescription benefit management. So, it wasn't a surprise to me that they chose to use them in their examples.

They also mentioned at some point their pharmacy network. I decided to look up their network to see which pharmacies are currently in it. I noticed that there are many independents in the network. At that point I was a little curious why the independents were not mentioned anywhere in the presentation, especially when they were going through the prescription benefits and in network pharmacies.

Understanding what I know about community pharmacy, I informed the gentleman sitting next to me that they didn't even mention the independents. He agreed that this was a little curious especially after I mentioned that almost half the prescriptions filled in the US are filled at independents. I told him that I was going to ask the presenters why they didn't mention the independents and he agreed to join me to hear the answer.

I walked up after the presentation and asked the presenter (she just happened to be a high ranking executive of the company) why there was no mention of the independents. She actually said to me, "I don't know." I then asked her if she knew what percentage of scripts in America are filled by independents. She said she did not know. I informed her and she was very surprised.

This is where the story gets good. I then set my sights on their relationship with Caremark. I asked her if Caremark pressured them to recommend mail order to their agents. She said that she would not comment on that. I then asked her if she ever gets concerned about what Caremark bills her company for the management of the drug plan. She asked me to elaborate. I told her of a story I once read where Express Scripts billed an insurance plan $485 for a drug and reimbursed the independent $20. And to top it all off, I said it cost the pharmacy $40 to purchase the drug. The first thing she said is that it is big pharma that is wreaking all the havoc on drug prices. She then said that the pharmacy needs to negotiate a better contract with the PBM. Once she finished, I acknowledged the issues she brought up are legitimate but they didn't answer my questions. I repeated my question, "Are you concerned about what Caremark charges your company for prescription drug management?" I will never forget her words. She said "Sir, I really appreciate your time and concerns, but there are other people who I need to speak with."

She essentially told me to take a hike in a very nice way. My immediate thought was, "I hope you are joking." This is a legitimate expense that all insurance companies need to look at because most of them aren't doing so well in our current environment. It makes me wonder what her motives were for moving on from our conversation. Maybe one day we will know the full truth.