Analysis ties local pharmacies to Medicare savings

Filling 90-day prescriptions is cheaper when Medicare beneficiaries do it at local pharmacies, according to an analysis released Tuesday.

The study is the latest shot between community pharmacists, who sponsored the analysis, and pharmacy benefit managers (PBMs). The two sides compete to serve Medicare beneficiaries, a vital and growing market.

According to the new study, local pharmacies provide a lower cost than PBMs per unit of medication, they also substitute cheaper, generic drugs more frequently (about 91 percent of cases compared with about 89 percent). 

The conclusions cut against other research that has forecast billions in potential savings for Medicare if the program used more "preferred" and "limited" pharmacy networks.

"The primary results … indicated that neither Medicare nor other third-party payers realized savings when patients used mail-order pharmacies," the analysis stated. "Further, when comparable days-supplies were dispensed, the total cost of using retail pharmacies was lower than the cost of using mail pharmacies."

The National Community Pharmacists Association (NCPA) praised the study and urged lawmakers to allow retail pharmacies to fill 90-day prescriptions in Medicare.

The group also railed against co-pay levels that incentivize the use of their competitors.

"This study blows a huge hole in the PBMs’ arguments that more mail order is the right prescription for Medicare Part D savings," said NCPA CEO B. Douglas Hoey in a statement.

"Local community pharmacists not only offer expert medication counseling face-to-face, but they also provide affordable access to prescription drugs and are leading the way in the appropriate use of lower-cost generic drugs."

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