InsideHealthPolicy.com's Daily Briefing - Powered by Dow Jones· US|January 19, 2022·09:35pm Update: This story has been updated to include a statement from the Pharmaceutical Care Management Association.
Independent pharmacists are threatening to stop dispensing coronavirus drugs if their dispensing fee isn’t raised, and the National Community Pharmacists Association is looking to CMS for help. Independent pharmacists are key to making coronavirus antivirals available in rural areas where patients are less likely to be vaccinated. “NCPA asks for immediate intervention before these pharmacies are forced to stop dispensing the oral antiviral drugs because they can’t justify the cost to their business,” NCPA CEO B. Douglas Hoey states in a letter to CMS Administrator Chaquita Brooks-LaSure.
Dispensing fees range from only $1 to $10.50, even though it takes at least an hour to dispense coronavirus antivirals, Hoey said.
The letter comes after the first allocations of several thousands of courses of Pfizer’s COVID-19 pill Paxlovid and Merck’s oral antiviral molnupiravir were distributed across the country starting in December. Both drugs received emergency use authorization from FDA in December.
There are 10 additional tasks associated with dispensing oral antivirals for COVID-19 that aren’t present during the usual dispensing process, NCPA says, including more time spent on the decision-making process for prescribers, gathering the prescription drug and medical history of new patients and offering extra patient counseling.
CMS in November had urged Medicare Part D sponsors to consider paying dispensing fees for government-procured EUA oral antiviral drugs that are higher than what is usually negotiated given the unique circumstances of the pandemic. The Pharmaceutical Care Management Association says pharmacy benefit managers have committed to make voluntary payments to pharmacies that are sufficient to ensure appropriate patient access to the oral antivirals.
NCPA says a dispensing fee consistent with the COVID-19 vaccine administration fee of $40 would be more appropriate given the extra work required of pharmacists and should be enforced.
But PBM Prime Therapeutics, enlisted by BlueCross Blue Shield, reportedly had paid as low as $1 and as high as $10.50 in dispensing fees, a range lower than the professional dispensing fee of many Medicaid programs, NCPA says. The group says this is especially disappointing considering the U.S. government has paid the drug makers over $500 per course of Paxlovid and over $700 per course of molnupiravir.
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