News Releases

NCPA Survey: Tamiflu Underpayments Cited by 88% of Independent Pharmacists

by NCPA | Jan 31, 2018

ALEXANDRIA, Va. (Jan. 31, 2018) — At the height of one of the most severe flu epidemics in recent years, pharmacy benefit managers are underpaying many independent pharmacies for Tamiflu or its generic equivalent, oseltamivir, leaving those pharmacies underwater on sales of the popular flu-fighting medications.

In a Jan. 22-24, 2018 National Community Pharmacists Association survey of independent pharmacy owners, 88 percent of respondents said that in the past 60 days they have experienced multiple incidences of reimbursements for Tamiflu or oseltamivir at rates below the pharmacy's acquisition cost for the medication.

"Many PBM contracts require pharmacists to dispense to a patient a medication they have in stock, regardless of whether it is at a loss," said NCPA CEO B. Douglas Hoey, Pharmacist, MBA. "As a result, many community pharmacies are having to eat the loss in order to see that their patients are cared for during one of the worst flu seasons in years. Some respondents are citing losses in excess of $60, even $70 per prescription.

"One could ask, are PBMs profiteering off independent pharmacies in the midst of a national flu epidemic? Underpaying pharmacists that are trying to help their sick patients is shameful behavior," said Hoey. "Yet underpayments like this happen to independent pharmacies on a range of different medications every day. It's representative of the way PBMs are making money at the expense of community pharmacies.

"Moreover, it's entirely possible that while PBMs are squeezing independent pharmacies on Tamiflu and many, many other medications, they may be billing the plan sponsor a much higher price than they reimbursed the pharmacy, and pocketing that excessive spread. In many instances when that is the case, the plan sponsor is none the wiser."

Many of the pharmacy owners surveyed also reported difficulty in acquiring various forms of Tamiflu or oseltamivir (capsules, suspension) in the past 60 days, NCPA said.

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The National Community Pharmacists Association (NCPA®) represents the interests of America's community pharmacists, including the owners of more than 22,000 independent community pharmacies. Together they represent an $80 billion health care marketplace and employ more than 250,000 individuals on a full- or part-time basis. To learn more, go to www.ncpanet.org, visit facebook.com/commpharmacy, or follow NCPA on Twitter @Commpharmacy.