Prime’s SIU team tracking the rise of drug-related schemes on social mediaFebruary 15, 2023
By Jessica Johnson, SIU Clinical Consultant, Prime Therapeutics
Discourse on the promises and perils of social media are certainly nothing new, however, Prime Therapeutics’ (Prime) Special Investigations Unit (SIU) has seen an increase in social media schemes threatening to put well-meaning individuals in jeopardy. What’s more, the schemes are potentially putting the health and wellbeing of others unassociated with the schemes at risk.
In recent months, a wave of social media posts have touted the weight-loss benefits of certain drugs. Saxenda® and Wegovy® are FDA-approved, glucagon-like peptide 1 receptor agonists (GLP-1) therapies for chronic weight management in adults, while Ozempic®, Victoza®, and Mounjaro®, which also are GLP-1 drugs, are used in the treatment for adults with type 2 diabetes but are not prescribed for chronic weight management.
The social media posts in question have led to a sharp increase in demand for GLP-1 drugs for both on- and off-label weight loss applications. This has led to a shortage of Mounjaro, Wegovy and Ozempic supplies, forcing diabetic patients who rely on these medications to seek alternative therapies.
Some of these trending diabetes/weight loss drugs currently require prior authorizations (PAs), as they may have side effects and interact with other medications. It’s also important that individuals taking these drugs do so in consultation with their primary care provider.
Another variable in these schemes is telehealth. While telehealth visits with or in connection to an individual’s healthcare provider are not the issue, the problem emerges when people use a resource they don’t know about. People may be obtaining medications through telehealth services and not actually talking to a provider, which may lead to patient safety issues as could gain access to medications without provider input. We also are seeing services not rendered. Some members report not receiving medications, billing errors, and worse, that their personal information has been compromised.
With all that’s at stake, there’s an urgency and an obligation for Prime and other PBMs to work with health plans to educate providers, pharmacies, members and clients about these drugs and the risks associated with these schemes. Here are some tips you can use to protect yourself and confront health care fraud:
Always consult with your primary care provider prior to starting a new medication
- Be aware of phony sales pitches over the phone, and do not disclose insurance or personal information
- Always be alert when you share information on online surveys
- You have the right to choose your provider and pharmacy to ensure they are in network – contact your health plan for more information
- Be diligent and in control of your own care
The Prime SIU team is committed to exploring this and other health care schemes that put people and our health care system at risk. Stay tuned for more on this issue in the months ahead.
March 9, 2023
Prime Together Foundation supports Casa Esperanza, New Mexico’s House of Hope
The Prime Together Foundation awarded a grant to Casa Esperanza, New Mexico’s House…
February 14, 2023
The Healthcare Businesswomen’s Association Rochester chapter honors Dr. Marci Chodroff with Everest Award for exemplary volunteer service
The Healthcare Businesswomen’s Association (HBA) Rochester chapter recognized Marci J Chodroff, MD, FACP,…
February 13, 2023
Prime again dominates the ACA market
Once again, Prime Therapeutics (Prime) is the largest pharmacy benefit manager (PBM) serving…