RIO GRANDE VALLEY, Texas (ValleyCentral) — Locally owned pharmacies are feeling the effects of changes to pharmacy benefit managers.
Pharmacy benefit managers are meant to help pharmacists with price negotiations, but with new limits on the PBMs, pharmacies are preparing for a negative financial impact that will be felt across the nation.
“In January, we’re gonna see a whammy. It’s going to be almost something what we’re calling an apocalypse, if you will, in the pharmacy world,” Bobby Muniz, Pharmacist with Muniz Rio Grande Pharmacy said.
President Joe Biden’s plan tries to prevent the PBM’s from having performance fees that will charge pharmacies based on performance.
“Based on whether a patient picks up their medications or taking their medications are several variables that go into these fees and often times, some pharmacies don’t even know about them,” Muniz said.
Because of this, the benefit managers are reducing how much they will reimburse pharmacies putting a huge toll on local pharmacies.
“Now these PBMs are pharmacy benefit managers are actually taking their contracts and they’re reducing the amount of reimbursement they’re going to provide to pharmacists for providing services,” Muniz said.
These new limits go into effect January 1st and will be taxing on local pharmacies, causing them to lose money on almost every prescription filled.
“So for that first quarter of 2024, from a from a cash flow performance standpoint, it’s really going to hurt independent pharmacies,” Muniz said.
Muniz says this will eventually affect patients because independent pharmacies will not take contracts with certain PBMs.
“Unfortunately, a lot of our patients are not going to be able to get their medications at their pharmacies because they’re no longer accepting that insurance,” Muniz said.