New oral antiviral medications might be game-changers against COVID-19, but distribution is likely to be affected if pharmacists continue to lose money dispensing them.
That's according to the National Community Pharmacists Association (NCPA), which blames "stingy fees paid by health insurance companies so far" in a letter to Centers for Medicare and Medicaid Services (CMS) administrator Chiquita Brooks-LaSure.
"While the reimbursement rates that NCPA members have reported may be higher than the usual negotiated dispensing fees, they are still far below these pharmacies' cost to dispense," the NCPA writes. "As of January 14, 2022, the highest enhanced dispensing fee reported is $10.50 with the low end being $1 by BlueCross Blue Shield's PBM Prime Therapeutics. These fees are lower than the Professional Dispensing Fee in most state Medicaid programs. Even the $10.50 dispensing fee fails to cover the additional costs required to optimize beneficiary safety and effectiveness for these breakthrough treatments. This is astounding and extremely disappointing considering the U.S. government has paid over $700 per course of therapy for molnupiravir and over $500 per course of therapy for PAXLOVID."
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