Long-Term Care Pharmacies Say Negotiation Hurts Them Without PBM Reform
By Luke Zarzecki
Inside Health Policy
Long-term care pharmacies say the kick-off of Medicare drug price negotiation Tuesday (Aug. 29), while well-intentioned, will inadvertently hurt them and their patients unless policy makers also move forward on pharmacy benefit manager and Part D payment reforms.
“Long term care pharmacies are likely to be collateral damage,” Alan Rosenbloom, president and CEO of the Senior Care Pharmacy Coalition, told Inside Health Policy.
Eight of the 10 medications included on the Part D price negotiation list unveiled Tuesday are heavily prescribed to patients in long-term care facilities. Those pharmacies lose money on most of the medicine they prescribe and only make a profit on a small portion they fill, the coalition said.
Rosenbloom cheered on paying less for drugs both for consumers and the government, but said more action is needed. He said pharmacy benefit managers and insurance companies are primarily responsible for high drug costs and policy changes need to be enacted.
With the new drug negotiations, he said if PBMs and insurance companies don’t add alternatives to their formularies, that could make long-term care pharmacies “existentially threatened” and leave some people in long-term care facilities without medication.
That’s the worst-case scenario, he said. To avoid it, SCPC calls for federal regulators and lawmakers to act.
Read the full original article here.
Recent Posts
-
Experts fear damage to long-term care pharmacies as CMS touts newly negotiated drug prices
Even as the federal government on Thursday touted the billions of dollars in savings seniors can expect to see from newly negotiated, lower drug costs, pharmacies that supply long-term care facilities are warning of dire consequences.
-
Senior Care Pharmacy Coalition & “Save Senior Rx Care” Release Statement on Biden Administration’s Medicare Drug Pricing Announcement
The Senior Care Pharmacy Coalition (SCPC), the leading national voice for the long-term care pharmacy community, and the new Save Senior Rx Care campaign released a statement today in response to the new drug pricing announcement: “Today, the Biden Administration released the negotiated 2026 prices for the ten most expensive Medicare Part D drugs, as […]
-
LTC pharmacies demand ‘sustainable’ payment model ahead of 2026 drug-pricing changes
Many of the nation’s long-term care pharmacies are going to fall below “break-even” and may be forced out of business without additional support when drug-pricing policy changes kick in, sector advocates warned Wednesday.
Stay in the Know
Get the latest news and updates on issues impacting the long-term pharmacy community.