Dispense Times Magazine

03/13/2026

Welcome to the U.S. Healthcare Casino. 🎰

A new analysis of hospital transparency files found something shocking:

The same drug at the same hospital can have completely different prices on the same day.

Examples:

• Keytruda (200mg): $12,000 – $43,000
• Opdivo: $17,000 – $67,000
• Ocrevus: $16,000 – $65,000

And it gets even crazier…

At the same hospital, one insurer paid $1 while another paid $2,347 for the exact same service.

Think about that.

Healthcare executives say pricing is “complicated.”

But pharmacists know the truth:

The system isn’t complicated.
It’s engineered to be opaque.

Meanwhile independent pharmacies get audited over pennies, while billions move through a system where the price of the same drug can swing $30,000+ depending on the contract.

Patients deserve transparency.
Pharmacies deserve fairness.
And the public deserves to know how the system actually works.

Source:
3 Axis Advisors analysis of 1,300+ hospital transparency files prepared for Patient Rights Advocate (reported by Axios).

03/13/2026

Peptides are one of the fastest growing areas in medicine.

The real question is:
Are independent pharmacies ready?

03/13/2026

The 'Last 5 Feet': Why your pharmacy should examine the Mark Cuban Cost Plus Drugs model. Operations, margins, and patient access insights for 2026. 📉

Get the insights at www.dispensetimes.com.

03/13/2026

It’s Friday the 13th.

For most people, it’s just a scary movie day.

For independent pharmacies… it can feel like every day.

The real horror story?

Pharmacy Benefit Managers.

They don’t manufacture drugs.
They don’t prescribe drugs.
They don’t dispense drugs.

Yet they can still decide:

• What pharmacies get paid
• Which drugs are covered
• Which pharmacy a patient must use
• Whether a pharmacy loses money filling a prescription

Imagine running a business where someone else sets the price below what you paid for the product.

That’s the nightmare many independent pharmacies face.

And when pharmacies disappear…
patients lose access to care.

🎃 What’s scarier than Friday the 13th?

A healthcare system where the middlemen control the entire runway.

03/13/2026

Sometimes Saving a Life Doesn’t Involve a Prescription

Pharmacy is one of the most stressful professions in healthcare.

Pharmacists, pharmacy technicians, and staff deal with constant pressure every day… high workloads, patient expectations, insurance problems, staffing shortages, and the responsibility of making sure medications are safe.

That stress adds up.

And sometimes the people around us may be struggling more than we realize.

Depression in pharmacy is real, but many people are afraid to talk about it because of the stigma. Some worry it will make them look weak. Others worry it could affect their career.

But the truth is this:

Depression is nothing to be ashamed of.

Human beings weren’t built to live in constant fight-or-flight mode, and pharmacy often feels exactly like that.

People also say pharmacists are “paid well,” but many don’t understand the reality of spending 8 years in school, taking on large student loans, and carrying enormous responsibility every single day.

And pharmacy technicians, who keep the entire operation moving, are often grossly underpaid for the level of work and pressure they handle.

Everyone struggles at some point in life. Sometimes more than once.

Medication can help some people, but it’s not always the full solution. Often there are underlying stressors that need attention too.

That’s why looking out for each other matters.

Some signs someone might be struggling include:

• withdrawing from coworkers
• sudden mood changes
• exhaustion or burnout
• talking about feeling hopeless
• increased irritability
• loss of interest in things they used to enjoy

If you notice someone struggling, sometimes the most powerful thing you can do is simply ask if they’re okay.

Listen without judging.

Encourage them to talk to someone who can help.

Most employers offer confidential counseling or employee assistance programs, often at no cost.

And if someone ever talks about harming themselves, take it seriously and help connect them with professional support immediately.

Law enforcement should usually be a last resort unless someone is in immediate danger.

Crisis counselors and mental health professionals are trained to help people through these moments.

Most importantly, remember this:

If you’re struggling, you are not alone.

It may not feel like things will get better in the moment, but they can and they do.

There are people who care about you more than you realize.

And sometimes the smallest act, noticing the signs and reaching out, can help save someone’s life.

You have value and if you think no one cares, I care.

03/12/2026

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03/12/2026

According to publicly reported compensation data, CVS Health CEO David Joyner received approximately $17.8 million in total compensation for fiscal year 2024. This included a base salary of about $1.1 million, along with stock awards, options, and other incentives.

At the same time, salaries for many CVS employees vary widely depending on role and location:

• Pharmacists: approximately $125,000 – $148,000 per year
• Pharmacy Managers: approximately $144,000 – $164,000 per year
• Store Managers: approximately $56,000 – $75,000 per year
• Pharmacy Technicians: approximately $32,000 – $48,000 per year
• Shift Supervisors: approximately $36,000 – $41,000 per year
• Customer Service Representatives: approximately $37,000 – $43,000 per year
• Cashiers: approximately $32,000 – $37,000 per year

Public filings also indicate the median CVS employee salary is around $60,917 per year.

03/12/2026

Menopause hormone therapy is finally getting the attention it deserves.

But now many women are running into a new problem…

They can’t get their prescriptions filled.

Across the country, patients are reporting shortages and delays for medications like estrogen patches, which are commonly used to treat menopause symptoms. Demand has surged in recent years as clinicians and patients have taken a fresh look at the evidence supporting hormone therapy. 

For many women, these therapies help manage symptoms like:
• hot flashes
• sleep disruption
• fatigue
• brain fog
• mood changes

But when supply chains fall behind demand, patients are left scrambling between pharmacies just trying to fill a prescription. 

This is a reminder that access to medication isn’t just about developing treatments.

It’s about making sure the healthcare system can actually deliver them to patients.

Pharmacists see these problems first — when the prescription is written, the patient shows up, and the medication simply isn’t available.

Women’s health has been overlooked for decades. If demand is finally rising, the supply chain needs to catch up.

Patients shouldn’t have to fight just to get the medications that help them function day to day.

Full story from NPR:
https://www.npr.org/2026/03/10/nx-s1-5742817/menopause-hormone-therapy-shortages

With the removal of FDA warning labels, hormone therapy to treat symptoms of menopause has grown in popularity. Now some patients are reporting delays in filling prescriptions for estrogen patches.

03/11/2026

Stop with the fines already.

When companies make billions of dollars, a fine is often just treated as a cost of doing business.

According to the U.S. Department of Justice, Aetna has agreed to pay $117.7 million to settle allegations that it submitted inaccurate diagnosis codes that inflated payments from Medicare Advantage.

But here’s the bigger question:

If companies can make 10x the amount before they get caught, what incentive is there to stop?

Fines often go back to the U.S. Treasury or government programs like Medicare, but that doesn’t undo the damage done to patients, taxpayers, and the healthcare system.

At some point we have to ask:

Are financial penalties enough to change behavior?

Or do we need real accountability for executives making these decisions?

Patients deserve transparency.
Taxpayers deserve honesty.
Healthcare shouldn’t be treated like a risk-reward game.

https://www.justice.gov/opa/pr/aetna-agrees-pay-1177-million-resolve-false-claims-act-allegations?fbclid=IwdGRjcAQenvhleHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEepIFY876jY2G-eZGcjkihO2EHp80GiRtw2uagdigMq0pfxjH2VU-PeW_bTqE_aem_5_UrTkMhxlUM14oQ6EXwlQ

Aetna Inc., a national insurer incorporated under the laws of Pennsylvania, has agreed to pay $117,700,000 to resolve allegations that it violated the False Claims Act by submitting or failing to withdraw inaccurate and untruthful diagnosis codes for its Medicare Advantage Plan enrollees in order to...

03/11/2026

Pennsylvania may become one of the first real tests of whether PBM reform actually changes the market or simply documents it.

There’s an interesting tension emerging right now between investor confidence and the intent of PBM reform.

After new federal PBM transparency provisions and the FTC settlement, The Cigna Group told investors during its February earnings call that the changes were not expected to materially affect margins or long-term growth.

According to reporting from The Wall Street Journal, the company’s stock rose 4.7% after CEO David Cordani said their PBM structure already aligns with the new rules.

Cigna owns Express Scripts, and with more than $190+ billion in projected 2025 revenue, analysts did not meaningfully revise forward margin expectations.

In other words:

Investors appear to believe business will continue largely as usual.

Pennsylvania may provide a real-world case study of whether that assumption holds.

In 2024, Josh Shapiro signed Act 77, a PBM reform law intended to increase oversight through expanded transparency and reporting on:

• Reimbursement methodologies
• Spread pricing
• Administrative fees
• Pharmacy network practices

Beginning April 1, 2026, PBMs operating in Pennsylvania must submit enhanced data that will establish the state’s first formal baseline for evaluating PBM practices under the new framework.

But something important is happening before that baseline even begins.

According to the Pennsylvania Pharmacists Association, nearly 190 community pharmacies closed in Pennsylvania between January 2024 and March 2025.

Pharmacy groups have cited reimbursement pressure and PBM contracting practices as major contributors, though closures can vary by operator and local conditions.

The timing sequence is what makes this notable:

• Federal PBM transparency provisions enacted under the Consolidated Appropriations Act, 2026
• Investors reassured margins remain intact
• Pennsylvania’s Act 77 signed July 17, 2024
• Pharmacy network removals and closures continue statewide
• Enhanced reporting baseline begins April 1, 2026

By the time Pennsylvania’s reporting baseline takes effect, the pharmacy landscape has already changed.

If pharmacies close or are removed from networks before enhanced reporting begins, the first round of transparency data may reflect a post-contraction market, rather than capturing reimbursement conditions before reform took effect.

That raises an important policy question:

Do transparency reforms change behavior or do they primarily reveal what has already happened after structural changes occur?

Pennsylvania’s rollout may offer one of the first real indicators.

And policymakers across the country will likely be watching closely.

03/11/2026

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03/11/2026

🏴‍☠️ THE SHIPS ARE COMING Michael Jones

Across the country, pharmacists are raising the pirate flag.

Why?

Because PBM games have gone on long enough.

Mississippi just passed HB1665 in the Senate with a 44–7 vote.

That’s overwhelming bipartisan support to bring fairness and transparency to the pharmacy system.

For years pharmacists have warned lawmakers about:

⚓ Spread pricing
⚓ Reimbursement disparities
⚓ PBMs paying their own pharmacies more than independent ones
⚓ Rural pharmacies being pushed to the brink

When an independent pharmacy closes, a community doesn’t just lose a business.

They lose access to healthcare.

They lose medication counseling.

They lose a trusted provider.

Now the bill heads back to the House.

The question is simple:

Will they concur?

🏴‍☠️ CONCUR RX HB1665