The National Community Pharmacists Association estimated that over 2,000 independent pharmacies closed between 2019 and 2023, citing PBM reimbursement rates that often fell below the pharmacys acquisition cost for certain drugs a phenomenon sometimes called DIR fees (Direct and Indirect Remuneration fees), which PBMs charged back to pharmacies after the point of sale
Either people really have to accept this as a treatment for life,, or we in science need to think really, really hard, how to support people when they stop the drug. While the study did not show causality, Jebb speculated that the difference in how fast people put weight back on could be due to the fact that diets are hard and people have to practise restraint to lose weight, whereas if you are taking a drug that knocks your hunger out completely, you dont have to make that effort
Integrated care matters here because the prescribers can actually adjust meds together rather than working at cross-purposes
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