LITTLE ROCK, Ark. (KTHV) — Your pharmacist could be losing money by filling your prescription or they’re forced to turn you away as a patient. That’s what hundreds of pharmacists in Arkansas claim.
It was a packed room in the MAC building Wednesday, Jan. 31 as pharmacists fought for lawmakers to bring change in the pharmacy world. An Arkansas State Legislature Special Committee is now looking into what needs to be done.
“This is a catastrophic event and cannot continue as a successful business model,” said Cissy Clark, a pharmacist in Earle, Arkansas.
She gave an example of filling a prescription for generic Tamiflu this year. She paid $87 for the drug but was reimbursed $36.23, meaning she would have lost money on the transaction.
"We’re not getting anywhere close to reimbursement, much less profit," said Dr. Laura Lumsden, Pharmacist at Remedy Drug. “It’s been going on for years, but it seems to have gradually gotten worse and had a snowball effect as of January 2018."
All fingers are pointed at Pharmacy benefits managers. They’re the middleman in the pharmacy world between insurance companies and pharmacies, responsible for handling all claims.
"There’s a middleman in the pharmacy benefit manager space that is charging the insurance company a higher amount, paying the pharmacy a lower amount and keeping the spread and it isn’t disclosed to anyone," said Dr. Scott Pace, CEO of the Arkansas Pharmacists Association.
One of the largest PBM’s is CVS Caremark. They had a representative defending the company saying they often lose money from transactions too.
Pharmacists are fighting for a fair cut, laws to be enforced, and oversight over PBMs.
"It’s really hit crisis level with pharmacists being paid below costs and being forced to turn patients away because they aren’t being paid enough by the insurance company," Pace said.
Those we spoke with on the special committee say they feel sure of one thing.
"Something needs to be done and the first thing is transparency," said State Representative Reginald Murdock. "We would hope they would have handled this themselves, but because the crowd you see today, obviously they have not so now we're in it and we're going to fix it for the people."
The committee wants to hear from more PBM representatives to the meeting will resume Tuesday.