'Enough is enough': APhA CEO calls for pharmacy reimbursement overhaul

Pharmacy reimbursements need to be totally restructured so patient care in pharmacies becomes profitable, American Pharmacists Association CEO Scott Knoer, PharmD, wrote in a July 21 blog post titled "Chaos in pharmacy reimbursement leads to patient safety issues, and enough is enough."

In the post, Dr. Knoer wrote that misaligned incentives have turned pharmacies into factories and that pharmacy benefit managers often reimburse pharmacies so low that they lose money on prescriptions, leading to pharmacy deserts and patients losing access to care. If pharmacists were to get paid for patient care, pharmacy chains would change their business model to take advantage of that, he stated.

"Chains aren’t to blame, and our sisters and brothers working in chains are overworked and underappreciated patriots serving society. The cause of our upside-down priorities is how our healthcare system pays for prescription drugs and patient care."

Dr. Knoer said that if the trend of widespread community pharmacy closures due to PBM "shenanigans and inadequate reimbursement" continues, community pharmacies will become extinct in the next five years. 

He wrote that pharmacists are the second-highest educated professionals in healthcare behind physicians and urged Congress to include provider status for pharmacists in the next package of coronavirus legislation.

"Pharmacists must be included in COVID-19 testing and immunization efforts if we are to get this pandemic under control."

Dr. Knoer also said that vertical mergers in the pharmaceutical industry must be policed to make sure they actually benefit patients and the public. 

"PBMs are already vampiric to the pharmacy industry, most obviously independent pharmacy. Now PBMs have their own pharmacies and have even integrated with insurers in some cases. There’s nothing that proves that such arrangements will benefit the public in any way."

Read the full post here.

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