For over 40 yrs, we have been allowing the insurance companies to determine our reimbursement rates and even to the services that are able to provide, because ever decreasing reimbursement rates.
When these programs began 1969-1970… basically they paid for the medication and the pt paid us to fill it… our fee and their copay was typically around $2.00.
The profession of pharmacy is going to have to get people to realize that our time is not free.. if it is going to financially survive.
Why not let the free market place determine what services the pts want and are willing to pay for.
If the PBM’s set up a fee schedule – percent or fixed dollar that the patient will pay of the drug cost and the pharmacy will be allowed to determine their “professional fee” for handling the prescription… on the receipt as a separate line charge. This will take the PBM out of determining who the winners and losers are.
The PBM’s can continue to get their kickbacks rebates from the drugs that are sold.. they still badger docs into using a certain drug…
If some pharmacy wants to charge a $1.00 fee.. go for it… but .. this will be a first step to establishing a consulting fee system for our advice… whether it is for OTC’s or any other reason that a pt feels the need to seek our advice… Have the fee scheduled posted at/near the register… no surprises..
I giant leap toward some transparency ?
Filed under: General Problems
Sounds like a good idea. But, I doubt it will ever happen. I keep wondering how these PBM’s can get kickbacks without getting in trouble with the law. And, this is especially questionable when it comes to the administration of Part D plans. Pharmacists are not allowed to get drug samples, but PBM’s can get kickbacks for using a particular drug. What is fair about this? Doc’s can no longer get drug company paid free meals, but the PBM’s can get kickbacks.