Pharmacies Weigh PBM Practices in US Drug Price Negotiation Plan

Independent pharmacies are increasingly concerned about potential unfair reimbursements under Medicare’s drug price negotiation plan, voicing doubts about the Biden administration’s final guidance outlining how it will monitor pharmacy benefit manager practices.

The PBMs functioning as middlemen between drugmakers, insurers, and pharmacies could pressure pharmacies to close their doors by not reimbursing the full negotiated price for drugs selected under the negotiation program, some pharmacy groups say.

When the Centers for Medicare & Medicaid Services finalized guidance on how it plans to implement the program, it raised questions about the impact on pharmacy revenue once the negotiated prices, referred to ...