Many independent pharmacists may decide or have already decided not to carry drugs in the Medicare Drug Price Negotiation Program due to financial challenges, the National Community Pharmacists Association (NCPA) told the Centers for Medicare and Medicaid Services (CMS) on Monday in a comment letter.
Through the program, the federal government is able to negotiate the price of selected drugs covered under Medicare Part D with participating drug companies. The first 10 drugs selected for negotiation were announced in August 2023, and the negotiated prices will take effect in 2026. An additional 15 drugs were announced this month, and these negotiated prices will go into effect in 2027.
NCPA is an advocacy organization representing more than 18,900 pharmacies. In its comment letter to CMS, it cited a recent NCPA survey of 8,000 pharmacy owners and managers. The survey found that 60.4% of independent pharmacists are weighing not stocking one or more of the first 10 drugs in the negotiation program. Another 32.8% have already decided not to stock one or more of the drugs. This is because the negotiation program will cause massive financial losses for the pharmacies.
Improving Medical Billing to Cut Payment Bottlenecks
Yusuf Qasim, President of Payments Optimization at Zelis, discussed how the company is transforming healthcare payments from a fragmented, patchwork system into a modern, digital infrastructure.
“That will be devastating to the program,” said NCPA CEO B. Douglas Hoey in a statement. “Patients who need these prescriptions will be unable to get them, because their pharmacies cannot participate in the program. It’s great the government removed big insurance’s PBMs from the negotiations and the result was lower prices for these prescription medications. That’s an important outcome for patients and taxpayers. But if almost no pharmacies can stock the drugs because they will sustain huge financial losses, the program will collapse before it even starts.”
The survey also found that 96.5% of independent pharmacists believe that PBM and plan reimbursement for Medicare Part D harm the “viability of their business.” In addition, 80.3% of independent pharmacists said their businesses’ financial health declined in 2024, and 48.6% said it declined drastically in 2024. About 30.3% of independent pharmacists are considering closing their business in 2025. The negotiation program could worsen these financial problems, according to NCPA.
“Pharmacies will have to float thousands of dollars every month waiting for refunds from the manufacturers. That will cause a massive cash flow problem in an environment where thousands of pharmacies have already closed,” Hoey said.
The NCPA made several requests of CMS, including preventing PBMs from mandating pharmacies to join the program as a condition for serving Medicare Part D patients.
The 3 Best Options to Buy Telemedicine Carts for Neurology Care
Neurologists and health care practitioners must evolve with the world. Telemedicine carts assist in this evolution by serving as an intermediary between patients and doctors.
Community pharmacists aren’t the only ones in opposition to the Medicare Drug Price Negotiation Program. Several drug manufacturers have filed lawsuits against the program, including Novo Nordisk, Teva Pharmaceuticals and AstraZeneca. So far, none of the drug companies have succeeded.
However, many other healthcare executives have come out in support of the program, including patient advocacy organization Patients for Affordable Drugs and AARP, a nonprofit for Americans aged 50 and older. These organizations argue that the program is finally providing relief for Americans struggling with rising drug prices.
Photo: megaflopp, Getty Images