Competition from large retail pharmacies, such as CVS and Walgreens, has often been cited as a primary reason for independent pharmacy closures. But Jim Blount, the owner of an independent pharmacy in Edenton, N.C., said the real issue isn't competition. It's the role pharmacy benefit managers play in determining prescription reimbursements, The Perquimans Weekly reported July 19.
Mr. Blount told the publication that he believes PBMs play a disproportionate role in determining what patients pay for prescriptions and how pharmacies are paid for dispensing prescriptions.
"What there ought to be is not pharmacy benefit managers but pharmacy benefit administrators," Mr. Blount said.
The pharmacy benefit administrator would be paid a reasonable fee for processing claims for prescriptions.
More insurers, which use PBMs to negotiate their prescription drug benefits, are imposing requirements that people use a specific pharmacy chain or mail order service to get their prescriptions, Mr. Blount told The Perquimans Weekly. That means fewer people have the option to fill their prescriptions at small, independently owned pharmacies.
Insurers are also paying less in dispensing fees, The Perquimans Weekly reported. Charles Woodard, the owner of an independent pharmacy in Hertford, N.C., told the publication that insurers pay a dispensing fee of just 15 cents for some prescriptions. Some also require pharmacies to sign contracts to dispense a 90-day supply of a prescription, which in many cases brings no fee for service.
Pharmacies used to be paid $1 to fill a 30-day prescription, Mr. Woodard told The Perquimans Weekly.
"The real reason that we're getting killed is not because of the competition. What's killing us is not the chains or the competition. The challenge for us is most of our living comes from prescriptions," Mr. Woodard said.
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