Many unbiased pharmacists might resolve or have already determined to not carry medicine within the Medicare Drug Worth Negotiation Program as a result of monetary challenges, the Nationwide Neighborhood Pharmacists Affiliation (NCPA) instructed the Facilities for Medicare and Medicaid Providers (CMS) on Monday in a remark letter.
By way of this system, the federal authorities is ready to negotiate the worth of chosen medicine coated beneath Medicare Half D with taking part drug corporations. The primary 10 medicine chosen for negotiation have been introduced in August 2023, and the negotiated costs will take impact in 2026. A further 15 medicine have been introduced this month, and these negotiated costs will go into impact in 2027.
NCPA is an advocacy group representing greater than 18,900 pharmacies. In its remark letter to CMS, it cited a latest NCPA survey of 8,000 pharmacy house owners and managers. The survey discovered that 60.4% of unbiased pharmacists are weighing not stocking a number of of the primary 10 medicine within the negotiation program. One other 32.8% have already determined to not inventory a number of of the medicine. It’s because the negotiation program will trigger large monetary losses for the pharmacies.
“That will probably be devastating to this system,” mentioned NCPA CEO B. Douglas Hoey in a press release. “Sufferers who want these prescriptions will probably be unable to get them, as a result of their pharmacies can’t take part in this system. It’s nice the federal government eliminated huge insurance coverage’s PBMs from the negotiations and the consequence was decrease costs for these prescription medicines. That’s an essential end result for sufferers and taxpayers. But when nearly no pharmacies can inventory the medicine as a result of they may maintain large monetary losses, this system will collapse earlier than it even begins.”
The survey additionally discovered that 96.5% of unbiased pharmacists imagine that PBM and plan reimbursement for Medicare Half D hurt the “viability of their enterprise.” As well as, 80.3% of unbiased pharmacists mentioned their companies’ monetary well being declined in 2024, and 48.6% mentioned it declined drastically in 2024. About 30.3% of unbiased pharmacists are contemplating closing their enterprise in 2025. The negotiation program might worsen these monetary issues, in accordance with NCPA.
“Pharmacies should float hundreds of {dollars} each month ready for refunds from the producers. That may trigger an enormous money circulate downside in an setting the place hundreds of pharmacies have already closed,” Hoey mentioned.
The NCPA made a number of requests of CMS, together with stopping PBMs from mandating pharmacies to affix this system as a situation for serving Medicare Half D sufferers.
Neighborhood pharmacists aren’t the one ones in opposition to the Medicare Drug Worth Negotiation Program. A number of drug producers have filed lawsuits in opposition to this system, together with Novo Nordisk, Teva Prescribed drugs and AstraZeneca. Thus far, not one of the drug corporations have succeeded.
Nonetheless, many different healthcare executives have come out in help of this system, together with affected person advocacy group Sufferers for Reasonably priced Medication and AARP, a nonprofit for People aged 50 and older. These organizations argue that this system is lastly offering aid for People combating rising drug costs.
Photograph: megaflopp, Getty Photographs