PCMA Urges CMS to Protect Financial Health of Pharmacies During IRA Implementation

December 10, 2024

EGWP Medicare

On Nov. 4, PCMA called on CMS to prioritize a regulatory model where pharmacies are not at “the mercy of big drug companies” who can delay reimbursements for Medicare negotiated drugs under final Inflation Reduction Act (IRA) guidance. The group argued that “Pharmacies should not be exposed to potential financial shortfalls because of a [drug] manufacturer’s preference on how to implement a statutory obligation.” If pharmacies aren’t protected, 90% of pharmacists recently surveyed by the National Community Pharmacy Association stated they will not dispense the 10 prescription drugs for which the government recently negotiated prices.

The law holds that drug companies are solely responsible to reimburse pharmacies for any difference between the price they acquire the drugs for and the new Medicare price set by the government. PCMA is calling on CMS to develop a simpler, fairer model for pharmacies and the patients they serve to ensure that their access to prescription drugs is uninterrupted. PCMA said PBMs have offered recommendations for how this can happen and stand ready to be collaborative partners in ensuring these very serious consequences are addressed appropriately.

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