Independent pharmacies may skip low-cost Medicare drugs

Duaine

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More than half of independent pharmacies are considering not stocking the first 10 drugs that were subject to Medicare price negotiations over concerns they'll have to absorb upfront costs.
Why it matters: If the drug stores decide it's not worth it to carry these drugs, seniors could have a harder time benefiting from the first round of reduced drug prices that take effect in 2026 — especially as more chain pharmacies close.

  • "Lower prices won't mean much to people who can't find the drugs," B. Douglas Hoey, CEO of the National Community Pharmacists Association, said in a news release.
The big picture: Independent pharmacies will absorb more than $27,000 in average monthly costs to stock the drugs, then have to wait at least a month for manufacturer rebates to come through, the trade association estimates.

  • The drugs in question include the popular diabetes medications Jardiance, Januvia, Fiasp and Farxiga; the blood-thinners Eliquis and Xarelto and treatments for arthritis, psoriasis, Crohn's disease and blood cancer.
Where it stands: 51% of independent pharmacies say they are "strongly" considering not stocking the drugs on Medicare's negotiation list because of cost considerations, according to survey results published Tuesday.

  • An additional 40% of pharmacies said they're "somewhat" considering not stocking the drugs.
  • About 465 independent pharmacy owners and managers responded to the survey. The trade group queried 4,135 pharmacy owners and managers between Sept. 24 and Oct. 11.
Between the lines: Independent pharmacists this summer asked Medicare administrators to ensure that they'd be reimbursed for the cost of acquiring and dispensing drugs on the price negotiation list.

  • The final guidance, released earlier this month, does not require dispensing fees for the negotiated drugs.



  • However, the Centers for Medicare and Medicaid Services said it will monitor complaints on the issue and encouraged insurers to provide fair reimbursement to pharmacies for dispensing the drugs.
  • During the implementation of the new negotiated prices, CMS will ask groups dispensing drugs to flag if they expect a cashflow problem while they wait for manufacturer rebates, an agency spokesperson told Axios. This information will be sent to manufacturers, and CMS will require manufacturers to outline a plan for mitigating dispensers' concerns.
Zoom out: Pharmacies' cost-benefit decisions about which drugs to dispense go beyond Medicare, the survey shows.

 
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