LITTLE ROCK, Ark.- Local pharmacies are struggling to keep their doors open after some big changes in the new year.
Pharmacists have been facing dramatic reimbursement cuts, which in some cases is creating access problems for patients with their prescriptions.
“They’re having to go to whoever they can find that’s willing to take a loss,” says Scott Pace, CEO of the Arkansas Pharmacists Association.
Laura Lumsden co-owns Remedy Drug on Markham. She says since the beginning of the year it’s been a lot harder to run her business.
“We’re having to cut corners in other areas to make sure that we can take care of our patients,” says Lumsden. “Something has got to change because they don’t sell cars or they don’t sell groceries below what the grocery store or car dealership buy them for.”
Since the cuts took place January 1, 2018, many local pharmacies are operating at a loss.
“In December, for one of the major health plans in Arkansas pharmacists were paid approximately $10.24 over the cost of their ingredient, so they could make a decent profit to be able to operate,” says Pace. “Since the first of the year that same major health plan in the state of Arkansas is reimbursing the pharmacies $4.26 below the cost of the ingredient.”
For several years insurance companies have used pharmacy benefit managers to make things easier for the patients to use their insurance and to reimburse pharmacists for the cost of drugs.
Pace says these middle men are largely unregulated.
“The health insurers are paying a fair amount of money to the PBM who is siphoning off money in the middle,” says Pace.
A practice that could soon put most community pharmacies out of business.
“It’s not that we’re making less profit and we’re complaining about that,” says Lumsden. “It’s that our claims are being paid below what we can purchase that medication for anywhere in the country.”
“Nobody has deep pockets so it’s not one of those scenarios where anyone can sustain that very long,” says Pace.