February 21, 2022 – According to The Wall Street Journal, pharmacists are getting paid “as low as a penny to about $10 for filling each prescription” by health insurers and pharmacy-benefit managers. The dispensing fee is meant to cover pharmacy services, staff, and overhead. Pharmacists are saying that the COVID-19 pill prescription takes “more than 30 to fill” and includes extensive patient counseling on how to take the prescription.
Even though the government paid billions of dollars for Paxlovid from Pfizer and molnupiravir from Merck and Ridgeback Biotherapeutics, it did not set reimbursement rates for health insurers and PBMs. Many pharmacists are saying that the fees being paid now won’t cover the cost of filling prescriptions, and some are even saying they won’t stock the pills at the current low reimbursement rates.
Pharmacies are calling for the government to intervene. Becker’s Hospital Review reports that “The National Community of Pharmacists Association trade group has urged CMS to recommend a fee similar to the $40 that Medicare pays pharmacies administering COVID-19 vaccines.” The National Association of Chain Drug Stores is also supporting a CMS recommendation but doesn’t have a specific amount.