Earlier this year, Medicare proposed a rule that will foster more robust competition among pharmacies, increase rural access and give seniors more convenient interactions with trained health professionals.
At issue are favorable deals between pharmacy benefit managers and big-box pharmacies. Medicare data show that these exclusive arrangements often raise Medicare costs while boosting these entities' profits. So it is no surprise these multibillion-dollar companies are seeking to derail the rule's implementation.
Currently, community pharmacies are routinely being denied the opportunity to participate in “preferred pharmacy” Medicare drug plan networks. Instead, local pharmacies are often contractually obligated to charge higher copays than “preferred” pharmacies. As a result, many seniors are steered toward those pharmacies chosen by their drug plan. By letting any pharmacy willing to accept a drug plan's “preferred pharmacy” terms and conditions participate, Medicare will increase access for patients, and we believe, lower copays.