Auditor McGuiness: Survey Shows Predatory PBM Practices Destroying Independent Pharmacies

DOVER, Del. – A survey of Delaware’s independent community pharmacists on the impact of pharmacy benefit managers (PBMs) reveals predatory practices are potentially devastating these small businesses, State Auditor Kathy McGuiness said today as she released a new special report.

“Your community pharmacists – who are your first line of defense when you are sick or hurting and need to talk – are struggling to keep their doors open,” said McGuiness, who is a licensed immunizing pharmacist and former small-business owner. “Our survey results show that these prescription drug middlemen, known as PBMs, are strangling these critically important community businesses.”

McGuiness’ office surveyed independent community pharmacy owners across Delaware in June regarding how practices by PBMs are affecting their businesses.

“The results were astounding,” McGuiness said. “The big three PBMs – CVS, Express Scripts Inc. and OptumRx, which control approximately 80 percent of the PBM market share – are using tactics that eat away at the thin profits these small-business owners fight to earn.

“What’s even worse is that the PBMs are trying to place Delawareans’ healthcare in the hands of big-box retail establishments.”

Among the survey results: 

  • PBMs’ use of one specific kind of fee that is imposed on pharmacies after a prescription sale has exponentially increased over the last few years. Known as DIR fees, these reduce or eliminate a pharmacy’s profit on a prescription transaction, and they are financially ravaging independent pharmacies. 
  • Delaware’s independent pharmacists report being squeezed by PBMs through lower reimbursements, exclusionary formularies and preferred pharmacies. By restricting increasing numbers of patients to mail-order-only pharmacies, PBMs are limiting access to medications. 
  • Delaware’s independent pharmacies suffer from similar problems noted in the 2019 National Community Pharmacists Association (NCPA) survey, which observed that greater oversight is needed “over the PBM corporations that contract with the state to manage prescription drug benefits for its Medicaid program and state employees.”

Read the new special report, “Predatory Practices: Survey Says Middlemen Destroying Delaware’s Independent Pharmacies,” on our website here.

Learn about the Delaware Auditor’s Office at https://auditor.delaware.gov.

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Contact:       

Anna Nuzzolese, Executive Assistant

302-857-3907

Anna.Nuzzolese@delaware.gov


West Nile Virus Is Detected in Sentinel Chickens in Delaware

No Human Cases of WNV Reported to Date in State

West Nile Virus (WNV) has been detected in Delaware for the first time in 2021 in sentinel chickens, the Delaware Department of Natural Resources and Environmental Control announced today. This first finding occurred in northern New Castle County at a sentinel chicken station sampled by DNREC’s Mosquito Control section on July 19. While there have been no reported WNV cases in humans this year in the state, Delawareans are reminded that the possibility of contracting mosquito-transmitted diseases, including WNV and Eastern Equine Encephalitis (EEE), will continue until colder autumn temperatures in mid-October or later.

Blood samples are collected by the DNREC Division of Fish and Wildlife Mosquito Control section each week from early July into October from the state’s outdoor-caged sentinel chickens that are humanely housed and handled at 20 monitoring stations statewide. The blood samples are tested for WNV and EEE antibodies by the Delaware Public Health Laboratory. Sentinel chickens bitten by mosquitoes carrying WNV or EEE develop antibodies to these diseases but are otherwise unaffected by them. WNV and EEE can be transmitted by mosquitoes to humans and horses.

Most people infected with WNV do not develop symptoms, but about 20% can develop a mild illness, which may include fever, body and muscle aches, headache, nausea, vomiting and rash symptoms. A small number of people can develop serious illness involving neurological problems, paralysis and possibly death. EEE is not as prevalent as WNV, but can present more severe symptoms in humans and horses.

DNREC reminds the public to take common-sense precautions to avoid mosquito bites, including wearing long-sleeved shirts and long pants when outdoors in mosquito-prone areas, applying insect repellent containing 10 to 30% diethyl toluamide (DEET) in accordance with label instructions and avoiding mosquito-infested areas and times of peak mosquito activity around dusk, dawn and at night.

Spraying to reduce mosquito populations in areas where WNV or EEE is detected may be initiated by the Mosquito Control section as warranted based on factors to include mosquito population levels and mosquito species present. To reduce mosquito-breeding habitat and chances of disease transmission, residents should drain or remove outdoor items that collect water, such as discarded buckets or containers, uncovered trashcans, stagnant birdbaths, unprotected rain barrels or cisterns, old tires, upright wheelbarrows, flowerpot liners, depressions in boat tarps, clogged rain gutters, corrugated downspout extenders and unused swimming pools.

The state veterinarian within the Department of Agriculture urges horse owners to contact their veterinarians as soon as possible to have horses and other equines vaccinated against WNV and EEE. Neither disease has a specific drug treatment, and infections in horses are fatal in 70 to 90% of EEE cases and in 30% of WNV cases.

More information about mosquitos and mosquito-borne diseases is available from the following resources:

  • For mosquito biology/ecology and control, contact the DNREC Mosquito Control section office in Dover at 302-739-9917.
  • For requests for mosquito relief in upstate areas from Dover north, contact Mosquito Control’s Glasgow field office at 302-836-2555.
  • For requests for mosquito relief in downstate areas south of Dover, contact Mosquito Control’s Milford field office at 302-422-1512.
  • For animal health questions, contact the Delaware Department of Agriculture’s Poultry and Animal Health Section, at 302-698-4500.
  • To report suspected cases of human WNV, call the Division of Public Health Office of Infectious Disease Epidemiology toll-free at 888-295-5156.
  • For more information on West Nile virus or Eastern equine encephalitis, visit www.cdc.gov/ncidod/dvbid/westnile/index.htm.

About DNREC
The Delaware Department of Natural Resources and Environmental Control protects and manages the state’s natural resources, protects public health, provides outdoor recreational opportunities and educates Delawareans about the environment. The DNREC Division of Fish and Wildlife conserves and manages Delaware’s fish and wildlife and their habitats, and provides fishing, hunting, wildlife viewing and boating access on nearly 65,000 acres of public land. For more information, visit the website and connect with @DelawareDNREC on Facebook, Twitter or LinkedIn.

Media Contacts: Nikki Lavoie, nikki.lavoie@delaware.gov; Michael Globetti, michael.globetti@delaware.gov

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DNREC, DPH Offer Tips About Ticks

Summer in Delaware is all about the great outdoors – biking and hiking, backyard and beach days, gardening and grass cutting. These time-honored summer activities can expose outdoor enthusiasts to unwanted guests – ticks. Depending on the type of tick, their irritating bite can transmit a variety of pathogens that can cause illnesses ranging from mild to serious.

The Delaware Department of Natural Resources and Environmental Control in partnership with the Delaware Division of Public Health have launched new web pages to educate the public about ticks, including where they are found, how to identify different types and what precautions to take before and after exposure to ticks, as well as information about tick-borne pathogens.

Tick facts include:

  • Tick Biological Aide Sierra Quiles, demonstrating tick-safe attire: light-colored clothing and pants tucked into socks. DNREC photos.
    Tick Biological Aide Sierra Quiles, demonstrating tick-safe attire: light-colored clothing and pants tucked into socks. DNREC photos.

    In Delaware, ticks are everywhere, but most bites occur in backyards.

  • Ticks do not jump or fall out of trees; they wait on grass or other plants for a host to walk by so they can grab on.
  • Ticks are active year-round, not just in late spring/early summer which is prime “tick season.”
  • Several different types of ticks are found in Delaware, and several types can carry different pathogens that can infect humans including Lyme disease.

Recommended precautions include:

  • Keep grass short and remove brush from the yard to reduce tick habitat.
  • Wear long pants tucked into socks and long sleeves in areas with high tick populations to help keep ticks from reaching skin.
  • When returning from outdoor activities, check for ticks and remove any from skin as soon as possible to reduce the chance of disease transmission.
  • Following exposure to tick-prone areas or tick bites, watch for symptoms of common illnesses caused by tick-borne pathogens and seek medical attention as needed.

For more information, visit the DNREC website at de.gov/ticks and the DPH website at de.gov/lyme.

About DNREC
The Delaware Department of Natural Resources and Environmental Control protects and manages the state’s natural resources, protects public health, provides outdoor recreational opportunities, and educates Delawareans about the environment. The DNREC Division of Fish and Wildlife conserves and manages Delaware’s fish and wildlife and their habitats, and provides fishing, hunting, wildlife viewing and boating access on nearly 65,000 acres of public land. For more information, visit the website and connect with @DelawareDNREC on Facebook, Twitter or LinkedIn.

Media Contacts: Joanna Wilson, joanna.wilson@delaware.gov; Michael Globetti, michael.globetti@delaware.gov

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DNREC to Hold Pharmaceutical Rule Training Webinar

The Delaware Department of Natural Resources and Environmental Control will host a training webinar Tuesday, June 22 to provide guidance for the state’s Pharmaceutical Rule adopted in January 2021, addressing changes to management standards for hazardous waste pharmaceuticals, as well as changes to the U.S. Environmental Protection Agency’s Final Rule P075 listing for nicotine waste.

The Pharmaceutical Rule intends to provide streamlined management standards for hazardous waste pharmaceuticals tailored to the health care sector, while protecting human health and the environment. While the training is directed at health care facilities who generate hazardous waste, the public also may attend.

The program will be presented by the DNREC Division of Waste and Hazardous Substances’ Compliance and Permitting section. Information about registering for the webinar can be found on the DNREC Events Calendar. The training webinar will be recorded and along with presentation materials, will be available on the DNREC website afterward.

About DNREC
The Delaware Department of Natural Resources and Environmental Control protects and manages the state’s natural resources, protects public health, provides outdoor recreational opportunities and educates Delawareans about the environment. The DNREC Division of Waste and Hazardous Substances ensures Delaware’s wastes are managed to protect human life, health, safety and the environment. For more information, visit the website and connect with @DelawareDNREC on Facebook, Twitter or LinkedIn .

Media Contacts: Michael Globetti, michael.globetti@delaware.gov; Nikki Lavoie, nikki.lavoie@delaware.gov

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DNREC Lifts Shelter-in-Place Directive for Area in New Castle County

The Delaware Department of Natural Resources and Environmental Control has lifted a shelter-in-place directive that spanned a half-mile radius around the crash scene of this morning’s accident on Interstate-95 involving a trailer load of organic peroxide, which is considered a hazardous material. The order for the crash scene applied to the area around the intersection of I-95 and Airport Road, and was lifted in midafternoon as I-95 southbound reopened in the accident aftermath as the scene was being cleared.

DNREC Emergency Response and Prevention section began burning off the peroxide at the scene shortly after 1 p.m. The unified incident command determined that it was a safer option for emergency responders and the public than attempting to move the material. There are expected to be no lingering air quality impacts.

About DNREC
The Delaware Department of Natural Resources and Environmental Control protects and manages the state’s natural resources, protects public health, provides outdoor recreational opportunities and educates Delawareans about the environment. For more information, visit the website and connect with @DelawareDNREC on Facebook, Twitter or LinkedIn.

Media Contacts: Nikki Lavoie, nikki.lavoie@delaware.gov; Michael Globetti, michael.globetti@delaware.gov

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