LTC pharmacies demand ‘sustainable’ payment model ahead of 2026 drug-pricing changes
By Kimberly Marselas
McKnight’s Long Term Care News
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.
The Senior Care Pharmacy Coalition is launching a new campaign for federal payment reform as the White House finalizes lower prices on 10 drugs widely used by Medicare beneficiaries and Congress toys with legislation that could loosen pharmacy benefit managers’ grip on most other US drug pricing.
Both efforts could have unintended effects on long-term care pharmacies, which have substantial dispensing costs associated with facility and patient services that commercial and independent pharmacies do not have.
“We have this precarious system when payers have been allowed to create a situation where they don’t pay for services,” said Alan Rosenbloom, president and CEO of the Senior Care Pharmacy Coalition. “The current perverse payment model was not something long-term care pharmacies ever wanted. It was handed to them because of the disproportionate negotiating power [PBMs] have.”
Read the full original article here.
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