Doing well by doing good: Corporate pharmacy shows you how

Sometimes there's nothing like a good cop show on TV, and as the deadline for this month's column approaches, I've wasted most of the afternoon remembering some of my favorites. There was a time in the ’90s when I never missed an episode of a series most famous for pushing the boundaries of what broadcast television would tolerate in terms of nudity and salty language. It wasn't seeing an occasional bare bottom or hearing words usually reserved for the locker room that drew me to the show, though. It was the writing.

If you paid attention, there was always a larger theme to the week's cases, as in the episode when a suspect's parents turned him in solely to collect reward money to feed their drug habit, while another was shielded from the police because his friends truly - and incorrectly, as it turned out - believed him to be innocent.

A situation in which the right thing was done for a bad reason and the wrong thing was done for a good one. Brilliant. And now that I think about it, I wonder whether any of the writers for that old show went on to work for the former CVS/Caremark, now known as CVS Health.

Nix the nicotine

For those of you who haven't heard, the PBM side of the company announced at the end of October that it will form a “tobacco-free” network of pharmacies that will require a patient to cough up an extra co-pay, reported to be as much as $15, to fill a prescription at any pharmacy that sells tobacco products. This comes after the announcement made earlier this year, with much fanfare, that tobacco would no longer be sold at CVS stores.

So CVS Health stops selling tobacco and then develops a plan that would charge people extra for going to a competing pharmacy that does. Evidently the company that pledged to be “agnostic” about where prescriptions are filled when the CVS/Caremark merger was under review has now found religion.

It's hard to see this move as anything other than a cynical, albeit brilliant, ploy to use the power that comes with being simultaneously one of the country's largest pharmacy chains and one of its largest pharmacy benefit managers to damage the other “Big Two” of the chain pharmacy world, Walgreen's and Rite Aid, both of which continue to sell tobacco at their thousands of stores.

Can’t lose

There's simply no way CVS can lose. Either:

1. Their competitors stop selling tobacco, costing them billions in revenue,

2. Their competitors risk losing prescription business, as customers end up at CVS, Target, or any of the vast majority of independent drugstores that quit selling tobacco long ago, or

3. Walgreen's and Rite Aid fight CVS, and maybe even win, while becoming known as the pharmacies that went to the mat to sell poison, losing credibility when making any claims to be concerned about their customer's health.

One could make a very good argument that this type of conduct is exactly why such “vertical integration” should be curtailed in the name of competition. Any business student could easily write a thesis drawing similarities to the bad old days of Standard Oil, railroad robber barons, or Andrew Carnegie's U.S. Steel.

Except for one thing.

Almost looks premeditated

Tobacco really shouldn't be sold in pharmacies, and the fact that these sales continue, more than 50 years after the Surgeon General officially linked tobacco to myriad health problems, we know all too well is ridiculous.

I'll come flat out and say it. Any entity that makes tobacco available to anyone has no right to claim any status as a healthcare provider. People who go into a place selling cigarettes are not patients, they are customers, there only to provide dollars to the owner in any way possible, whether it be through the purchase of health or the purchase of death.

No amount of money could ever convince me to sell tobacco in my store, and its elimination from our profession would be nothing but a good thing. But ... allowing a huge corporation to take advantage of the synergy of a recent merger to damage its rivals just seems so ... wrong.

A good thing, done for the wrong reasons.

Which brings me back to that TV show.

Brilliant.