Covid Vaccinations are Free — But They're Taking a Toll on Local Pharmacies' Bottom Lines

Pharmacists may be on the front line of Covid-19 vaccination distribution, but they feel increasingly like an afterthought when they try to get paid for it.

A common complaint among community pharmacists is that they are sapped physically, mentally and financially by hours of paperwork, piles of rejected claims and unceasing billing audits just to receive some level of payment for administering vaccines. And it’s a problem that could push some of these small businesses to the brink financially.

Every week, Chris Antypas said he and his staff at Asti's South Hills Pharmacy in Pittsburgh are making the same calculation as many other mom and pop pharmacists: Though they have inoculated thousands quickly and effectively, can the business afford to continue?

The vaccine may come free — paid for by the federal government — and administering it is fairly easy, but the work behind those shots is monumental, the reimbursement rates from insurers can be low and the effort to get paid is a major undertaking.

“It's a shot in the arm for sure to know that you're helping people,” said Antypas, who has worked 80- to 100-hour weeks running vaccination clinics while still operating a high-volume pharmacy. “But we're certainly sacrificing our business, and it’s already difficult to be profitable. It's just a drain on you.”

Image: Julia Gadsby, who has lupus, receives the Pfizer-BioNTech vaccine
NBC News spoke to 10 community pharmacists in five states: Georgia, Pennsylvania, Florida, New York and Illinois. Seven obtained the vaccine despite the hurdles they faced, while three said the difficulty of securing a regular vaccine supply, billing issues and low reimbursement rates, particularly from private insurers and state Medicaid programs, discouraged them from participating in the nationwide effort.

All who had a vaccine supply emphasized that, despite the excessive paperwork and financial hardships, vaccinating their communities remained one of the most rewarding experiences of their lives.

Pharmacists' vaccination efforts have already been huge: The Federal Retail Pharmacy Program has tapped more than 40,000 pharmacies nationwide and accounted for hundreds of thousands administered vaccines. A large and particularly effective portion of that number are independent pharmacies.

But at this point, they have mostly vaccinated people covered by Medicare, the federal insurance for those older than 65 that has set the standard for vaccine reimbursement rates. Still, even Medicare has had issues in providing payment because it still does not fully recognize pharmacists as providers that deliver medical services, drawing attention from lawmakers and trade groups.

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