NCPA outraged at low reimbursement for generic Zocor

July 24, 2006

Complaints from NCPA members have been steadily building over low maximum allowable cost (MAC) reimbursement from Express Scripts for generic Zocor. According to NCPA, it has received numerous reports that Express Scripts, one of the largest PBMs in the country, has set a MAC for simvastatin at approximately two-thirds of the pharmacy acquisition price.

NCPA outraged at low reimbursement for generic Zocor

Complaints from NCPA members have been steadily building over low maximum allowable cost (MAC) reimbursement from Express Scripts for generic Zocor. According to NCPA, it has received numerous reports that Express Scripts, one of the largest PBMs in the country, has set a MAC for simvastatin at approximately two-thirds of the pharmacy acquisition price. The association has also reported that other PBMs may be following suit. NCPA has met with members of Congress in an effort to correct what it called "an abusive practice." On a related note, the association reported that some PBMs have moved Zocor into a tier-one or generic co-pay category, reimbursing pharmacies at the generic rate even though the plan is requiring that Zocor, a brand drug, be dispensed.

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