Ohio small pharmacies say they're fighting to survive on CVS Caremark reimbursements

Owners of small pharmacy chains in Ohio say reimbursements from CVS Caremark have gone down over the last year, making it hard for them to stay in business, The Columbus Dispatch reported. 

CVS Caremark, the pharmacy benefit management branch of CVS Health, determines reimbursement rates for three of the five Ohio Medicaid providers. Pharmacies need to be reimbursed about $10 more than what they pay for a prescription to cover costs, according to the Dispatch

Andy Becker, PharmD, director of pharmacy operations for a small pharmacy chain in Ohio, West Virginia and Kentucky, told the Dispatch that reimbursements from CVS Caremark fell from $5 to $6 above cost to about $2 above cost. 

Express Scripts, the pharmacy benefit manager that replaced CVS Caremark for Ohio's biggest Medicaid provider, Caresource, reimburses at $7 above cost, the Dispatch reported. 

CVS Caremark's reimbursement rates "make it unclear if Medicaid pharmacies in Ohio will be able to survive," Dr. Becker told the Dispatch

Antonio Ciaccio, director of government and public affairs for the Ohio Pharmacists Association, told the Dispatch that hundreds of Ohio pharmacies have been forced out of business in recent years. Independent drugstores and small pharmacy chains are often the only pharmacies available in small Ohio towns. 

A CVS spokesperson told the Dispatch the company is not intentionally underreimbursing pharmacies. 

A Medicaid spokesperson told the Dispatch there is "no indication of concerns or questions raised this year by pharmacists or others regarding CVS Caremark’s pharmacy reimbursement rates for generic prescriptions."

Becker's Hospital Review has reached out to CVS for comment and will update this story accordingly. 

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