Pharmacy groups are calling for higher dispensing fees for COVID-19 antivirals, saying adequate payment is needed to ensure broad access to the crucial treatments, according to Bloomberg Law.
The fees cover the cost of pharmacy staff and services to dispense and fill prescriptions. The National Community Pharmacists Association and American Pharmacists Association said most dispensing fees for COVID-19 antivirals range from $10.50 to just $1. NCPA argues this fee should be closer to the $40 fee Medicare requires for one dose of a COVID-19 vaccine.
CMS strongly recommends health plans' pharmacy benefit managers pay dispensing fees for antivirals, but the agency does not mandate a set amount as it does with vaccines.
Some pharmacies — especially smaller, independent ones — are questioning whether to offer antivirals, as they may be unable to financially make up the time it takes to dispense the medications, according to Bloomberg Law. Jennifer Palazzolo, owner of Flatirons Family Pharmacy in Longmont, Colo., is one such pharmacist who's opted not to offer the medications.
"It's not the best feeling, but sometimes as a business owner you have to make hard decisions," she told CBS Denver.
Pharmacy groups are urging CMS to require set COVID-19 dispensing fees for antivirals to preserve patient access to the medications.
With no federal mandate, some states are talking matters into their own hands. On Feb. 8, the Arkansas Board of Finance voted to increase the dispensing fee paid by the state's Employee Benefits Division from a maximum of $1.50 to $20 for COVID-19 antivirals, according to the Northwest Arkansas Democrat Gazette.
A CMS spokesperson told Bloomberg Law the agency has encouraged health plans to pay higher-than-normal dispensing fees for antivirals and said it is committed to ensuring Americans have access to COVID-19 therapeutics.
The Pharmaceutical Care Management Association, a trade group representing PBMs, said they are "making voluntary payments to pharmacies in order to maintain appropriate access to the medications for patients" in an emailed statement to Bloomberg Law.