Pharmacy Today

From birth through the final stages of life, the independent pharmacy has provided for the community patient throughout their care in both the retail and long term care settings.

Unfortunately, the ability to provide this care moving forward is being threatened. In the retail setting, the independent pharmacy is in the fight of its life as managed care pharmacy benefit managers (PBM’s) exclude them from participation in preferred pharmacy networks and limit their reimbursement–threatening their profit margin and longer term survival. In the long term care or hospice sector, the independent pharmacy has been relegated to a role of dispensing emergency medications through the control of third party drug managers who act as middle men. The third party drug manager directs hospice patient business to mail order services outside of the community, using the local independent pharmacy as only a dispensing service back-up for limited days and secondary fills. In the early years of hospice care, it was the local independent pharmacy that worked directly with the hospice agency to respond to the clinical and medication needs of the patient.  

According to the 2008 National Community Pharmacy Association (NCPA) Survey, 2 out of every 3 independent pharmacies dispensed medications to hospice agencies. In 2010, this same NCPA survey reported that this percentage was reduced to 1 out of every 3. This illustrates the dramatic market shift that has taken place over a very short period of time with third party administrators displacing independent pharmacies as the primary provider.

As this market shift to third party administrators (TPAs) has taken place, hospice agencies are questioning the value of the program as their drug costs continue to increase. They are recognizing that the third parties have created undisclosed revenue sources by retaining the difference between the hospice contracted rate and the pharmacy reimbursement. They are concerned that they need more active participation with the local independent pharmacy for improved clinical patient outcomes. Hospice agencies want to expand the role of the local independent pharmacy to achieve improved patient care and reduced drug costs. The Independent pharmacy recognizes the opportunity for hospice care to become an important business with the potential for improved reimbursement and increased drug volume when the TPA is replaced.

Read about the Hospice Today

Learn about the Pharmacy to Hospice administration program

See the Facts & Figures