In neighboring Oklahoma, Justin Wilson, PharmD, co-owns ValuMed Pharmacy in Midwest City and six other independent pharmacies. He says his long-term relationship with patients—some of whom began seeing his pharmacist father in the 1970s— makes it easier to talk dollars and cents with them. He uses various strategies to make their medications more affordable.
“We work with them and their physicians to get them on alternative medications to help reduce those costs. If they’re on Medicare, we work with them on getting manufacturer assistance program cards that help with the copay as well,” he says. “We’re pretty proactive with our patients, and I think that’s helped us to at least be a little more successful at dealing with those concerns.”
In addition to responding to patient-frustration associated with rising drug costs, pharmacies are also dealing with the toll that it is taking on their businesses in the form of lower reimbursements.
One National Chain Reacts
The pressure to address soaring prescription drug prices has become a top priority for independent as well as chain pharmacies. In April, CVS Health announced a comprehensive program called CVS Pharmacy Rx Savings Finder to help patients save money. CVS is rolling out the program to CVS Caremark PBM members and expects to gradually expand it this year.
Chief policy and external affairs officer Thomas Moriarty says the new program will help all parties to the transaction manage costs. “CVS Health is giving expanded tools to patients, prescribers, and pharmacists so they can evaluate prescription drug coverage in real-time and identify lower-cost alternatives,” he said when the program was announced. “We are committed to finding the right drug at the lowest possible cost for patients to ensure they are able to access and stay on the medications they need.”
Pharmacists can use the program to determine if the prescribed medication is on the patient’s formulary and is the lowest cost option. They can also learn if lower-cost options with equivalent efficacy of treatment are covered under the patient’s pharmacy benefit, or if the patient may save money by filling a 90-day prescription rather than a 30-day one. If a generic or lower-cost alternative is not available, the program provides other potential savings options for eligible or uninsured patients, where allowed by applicable laws and regulation.
The new tool enhances existing savings opportunities that CVS Caremark offers, including preventive drug lists that make medications for many common chronic conditions available at no copay. The PBM also provides realtime, member-specific drug costs and lower-cost alternatives to prescribers through their electronic health record system and to CVS Caremark members through the member portal and app. The company’s point of sale rebate also passes along negotiated rebates on branded drugs directly to patients when they fill their prescriptions.
Walgreens declined to comment specifically on the pricing issue.