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This is another way CVS and Walgreens are adding health services to their stores to keep people coming in, with more and more dollars being spent online...SmileDirectClub has opened six locations inside CVS stores to fit people’s teeth for invisible aligners...Walgreens has opened an Aspen Dental office in one of its Florida stores in December...You can already get checked and treated for strep throat at many drugstores. You can now get your teeth cleaned and straightened at some...People are shopping more online. That’s a problem for drugstores, so Walgreens and CVS are getting creative...It all boils down to trying to diversify what they’re offering in the front of the store...

Grand River Hospital and Medical Center, a 13-bed critical access hospital in Western Colorado which sees an average of seven patients a day, has saved about $300,000 in staffing costs by using telehealth tools to establish a round-the-clock pharmacy...Telehealth products and services is on the rise among small and rural hospitals...for instance, NewYork-Presbyterian forged a pact to provide emergency physicians via Walgreens in-store kiosks...Cleveland Clinic inked an arrangement with CVS to use American Well’s telemedicine platform to make clinicians accessible for visits from CVS Minute Clinics in Ohio...Telepharmacy has become its own specialty among tech vendors, including CPS TELEpharmacy, eVisit, PipelineRx, ScriptPro Telepharmacy and TelePharm...Nancy McClew, PharmD, director of pharmacy at Grand River Hospital and Medical Center, said the investment in the telemedicine technology is well worth it compared with the cost of staffing the pharmacy 24/7...“Grand River also has generated savings through tele-pharmacist interventions, the majority of which are safety related – clarifications, QI, prevention, renal assessment, therapeutic,” McClew said. “In Q3 2017, pharmacists documented more than 350 interventions, representing more than $50,000 in cost savings.”

The pharmacy community is working to make sure Florida residents are prepared as Hurricane Irma bears down on the state. Gov. Rick Scott authorized pharmacies to dispense up to 30-day emergency prescription refills to patients...In addition, CVS Pharmacy and Walgreens are emphasizing the importance being prepared by keeping prescriptions stocked, or at least on-hand. "Prescription preparedness is one of the most important steps individuals and families can take in the lead up to potentially severe weather, and CVS Pharmacy is working to ensure that our patients have the medications they need in advance of the storm," says CVS Health EVP retail pharmacy and supply chain Kevin Hourican. Walgreens is reminding patients to follow evacuation orders and get to a safe location before refilling their prescriptions, noting that all locations can access a patient's records and that the Walgreens app can be used to refill prescriptions and pick them up nearby.

Some ailing veterans can now use their federal health care benefits at CVS "MinuteClinics" to treat minor illnesses and injuries, under a pilot program announced...by the Department of Veterans Affairs...The new program, currently limited to the Phoenix area, comes three years after the VA faced allegations of chronically long wait times at its centers, including its Phoenix facility, which treats about 120,000 veterans...The Phoenix pilot program is a test-run by VA Secretary David Shulkin who is working on a nationwide plan to reduce veterans' wait times...Veterans would not be bound by current restrictions under the VA's Choice program, which limits outside care to those who have been waiting more than 30 days for an appointment or have to drive more than 40 miles to a facility. Instead, Phoenix VA nurses staffing the...medical center's help line will be able to refer veterans to MinuteClinics for government-paid care when "clinically appropriate."..."We believe in the MinuteClinic model of care and are excited to offer our health care services as one potential solution for the Phoenix VA Health Care System and its patients," said Tobias Barker, chief medical officer of CVS MinuteClinic...

Amazon is running into challenges in its drug distribution push...Amazon's potential leap into pharmaceuticals has weighed on drug distributors and pharmacies for months, but those companies are getting relief from news that the online retail giant has put at least one of its plans on ice...a unit that sells bulk products to companies—hasn't been able to convince hospitals to get on board with its plan. One reason: The company doesn't have a proper cold-chain logistics network, which is crucial to distributing many drugs...Amazon has now backed away from the effort, the publication reported...The company is pressing ahead with other healthcare projects, though it's unknown whether they involve pharmaceutical sales...

CVS is reportedly in talks to buy Aetna in a deal that could help protect its business from the entry of the tech giant in to the healthcare space...CVS should focus on its vertical integration strategy, according to Morgan Stanley, and steer clear of gong head to head with Amazon in next day or same day delivery...Don't go head-to-head with Amazon...Goldwasser said that CVS' strength is its vertical integration. CVS has made a number of acquisitions over the past decade, such as Caremark RX, a pharmacy benefits manager, Omnicare, a leading pharmacy services provider and Target's pharmacy and retail clinic businesses. That push puts the company on a better footing to engage consumers, improve access to care, and deliver cost savings, he said.Goldwasser said however that any plans to go head-to-head with Amazon in next-day or same-day delivery service of prescriptions may impact the company's front-store sales. CVS already offers this service and plans to expand it to all of its locations in 2018.

PBMs occupy a key crossroads of the health system, acting as a nexus among insurers, employers and drug companies. Through a complex web of agreements they help decide what drugs are covered by a patient’s insurance, and how much they’ll cost at the pharmacy counter. The problem, say critics, is that opacity makes it hard for employers to know how much the PBM is paying and profiting on each transaction -- an impression reinforced by restrictions on who can audit them and how.

• Swelling Costs - President Donald Trump has repeatedly complained about high drug prices
• Wrangling Rebates - The most carefully guarded secrets of the PBM industry involve tens of billions of dollars in rebates they collect from drug companies. Those payments help drugmakers secure favorable spots on medication menus that PBMs offer to millions of patients.
• Other Avenues - Rebates are only one way drugmakers pass money to PBMs. Others include fees for care management, administration and inventory procurement.

While industry watchers were eagerly anticipating Amazon’s move into prescription drugs, the e-commerce behemoth snuck into over-the-counter sales with help from store brand expert Perrigo...Amazon rolled out a line of consumer health products, called Basic Care...The portfolio—consisting of 60 Perrigo-made treatments—sets Amazon up to put the squeeze on retailers of OTC therapies...Amazon already sells branded OTC products...including those from Perrigo’s GoodSense brand...But with Basic Care, Amazon can undercut its competition to reap just a hair in the profit margin column...just because Amazon’s got the lowest prices doesn’t mean consumers will consistently order the Perrigo brands online instead of running out to a Walgreens or CVS when they need something.

Even before reports surfaced...claiming that CVS Health was in talks to buy Aetna, the nation’s third-largest health insurer, the two were known to be discussing forming closer ties...But a full-blown merger of the healthcare giants would be complicated and unlikely given recent antitrust scrutiny in the sector and given that the drugstore chain is already going into business with an Aetna rival, Anthem...Anthem just last week said it was forming its own pharmacy benefit management company, IngenioRx, with CVS, which operates a PBM. That was seen as a way to compete with the nation's largest health insurer, UnitedHealth Group, which owns the PBM OptumRx...But for CVS to operate a PBM with Anthem, the No. 2 health insurer, while owning Aetna, the No. 3 insurer, would be highly unusual coming off a period of intense antitrust scrutiny of the health insurance industry.

Buried deep in its first quarter earnings filing with the Securities and Exchange Commission, Eli Lilly & Co. disclosed it is being investigated for insulin pricing practices by the attorneys general of New Mexico and Washington. The Washington AG is looking at Lilly's relationship with pharmacy benefit managers...Insulin competitor Novo Nordisk has also said it is under investigation by the two AGs for pricing and trade practices for its insulin products, going back as far as 2005...Things are getting complicated at the moment for the big three in insulin. As well as the investigations by the attorneys general, last month, Sanofi, Novo Nordisk and Lilly, along with the pharmacy benefit managers CVS, Express Scripts and UnitedHealth's OptumRx, were slapped with a complaint and demand for a jury trial from the Type 1 Diabetes Defense Foundation.