NCPA Reacts to OptumRx Cost-Plus Announcement: Actions Will Speak Louder Than Words

The National Community Pharmacists Association (NCPA) issued the following statement today in response to OptumRx’s announcement that it plans to introduce a cost-plus prescription reimbursement model, that they say would reimburse pharmacies for the cost of acquisition for brand and generic prescriptions they dispense, plus potentially a dispensing fee:

“Their current reimbursement model is certainly broken. It frequently reimburses independent pharmacies less than it costs them to acquire and dispense prescriptions. Independent pharmacies are incurring heavy losses as a result, and many are on the brink of closure. While we would welcome a new approach to prescription reimbursement that fairly pays pharmacists for their dispensing and patient care services, we would need to see the details of their plan before we can assess it. NCPA remains hopeful that at least one of the Big 3 PBMs wants to address the prescription payment issues that affect pharmacies’ ability to stay open and care for their patients.

“We have seen announcements like this in the past by PBMs that claim they want to work with independent pharmacies. Based on the results to date, some were obviously intended as political cover or public relations. If this is a good-faith effort, it would be a good first step in reimbursing all independent pharmacies for the actual cost of acquiring drugs, plus the cost of counseling patients, serving patients, inventory, supplies, and other overhead. Otherwise, this will be another cost-shifting gambit that will leave independent pharmacies in the same position. In either event, federal PBM reform remains essential to provide stability, transparency, and predictability for patients and pharmacies.”

For more information about NCPA, please visit www.ncpa.org. Follow NCPA on social media @commpharmacy.