A new report released by the Office of the Inspector General on independent pharmacy payments in Medicare Part D will "raise eyebrows" on Capitol Hill and essentially refutes claims from the independent drugstore lobby, said officials from the Pharmaceutical Care Management Association (PCMA).
"This report will raise eyebrows among policymakers who have been led to believe that independent pharmacists were in dire straits because of the Medicare drug benefit," said PCMA President and CEO Mark Merritt. "It runs counter to rhetoric from the independent drugstore lobby on the need for costly legislation granting pharmacies special antitrust exemptions and payment cycles that are twice as fast as those received by doctors and hospitals."
- Independent pharmacies are paid an average of 18 percent more by Part D plans than their acquisition costs for medicine.
- On average, Part D payments to rural pharmacies exceed payments made to urban pharmacies.
- Two-thirds of community pharmacies belong to group purchasing organizations that allow them to collectively bargain -- and achieve -- higher Part D reimbursement rates.
According to a separate analysis by CRA International, pharmacy antitrust exemptions would increase prescription drug costs for Medicare and commercial payors by up to 11.8 percent, or $29.6 billion over five years. Legislation that would make Medicare prescription drug plans pay drugstores twice as fast as Medicare pays other providers could cost the program and its beneficiaries at least $3.1 billion over the next decade, according to a recent study from PricewaterhouseCoopers.
