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As flu spreads, Tamiflu at issue

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Without a doubt, pharmacies of all stripes are being challenged in this busy flu season, as the number of cases nationwide continues to escalate.

Just go to any drug store, and you’ll likely see a queue at the pharmacy counter and a steady flow of concerned-looking people entering and exiting the cold/cough medicine aisles.

Tamiflu_ oseltamivir_capsulesThis run on pharmacies unsurprisingly has led to shortages, most notably (if you’ve seen the headlines) with the flu-symptom-easing drug Tamiflu. This writer found out about the supply shortfall firsthand when my daughter came down with flu (I followed suit two days later). At the pediatrician’s office, the nurse informed us that Tamiflu (branded or generic) currently wasn’t available at any nearby chain pharmacies.

Fortunately, a local independent pharmacy (a Leader network pharmacy) came to the rescue with some generic Tamiflu for my daughter. (And when I went to pick up the prescription, I immediately saw that this store, too, had its hands full serving ailing customers.) Her condition improved not long after taking the medication.

What I didn’t realize at the time was that filling prescriptions for Tamiflu or its generic equivalent, oseltamivir, comes at a cost for many independent pharmacies.

In a recent survey by the National Community Pharmacists Association, 88% of independent pharmacy owners said that in the past 60 days they had multiple cases of reimbursements for Tamiflu or oseltamivir at rates below the pharmacy’s acquisition cost.

Also, many of the pharmacy owners polled also encountered difficulty in acquiring various Tamiflu/oseltamivir forms — capsules or suspension — in the past 60 days, NCPA added.

“Many PBM contracts require pharmacists to dispense to a patient a medication they have in stock, regardless of whether it is at a loss,” according to NCPA chief executive officer B. Douglas Hoey. “As a result, many community pharmacies are having to eat the loss in order to see that their patients are cared for during one of the worst flu seasons in years. Some respondents are citing losses in excess of $60 — even $70 — per prescription.”

PBMs may be “squeezing independent pharmacies on Tamiflu,” Hoey suggested.

“One could ask, are PBMs profiteering off independent pharmacies in the midst of a national flu epidemic? Underpaying pharmacists that are trying to help their sick patients is shameful behavior,” he stated. “Yet underpayments like this happen to independent pharmacies on a range of different medications every day. It’s representative of the way PBMs are making money at the expense of community pharmacies.”



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