Alexandria, VA—A new survey suggests that Americans are pushing back against insurance plans that dictate which pharmacies and medications they can use.
The poll sponsored by the National Community Pharmacists Association (NCPA) also found that respondents disapproved of PBMs shortchanging pharmacies on reimbursement for COVID-19 and other medications.
The survey of 716 registered voters was conducted in mid-February by Public Policy Polling.
The strongest response was on the question about health insurance plans and PBMs "steering" patients to specific pharmacies—84% of those answering the survey said they disapproved.
In addition, 78% said insurance plans and PBMs should not be able to require patients to use pharmacies they own or to be able to dictate that drugs be received through the insurance company's mail-order pharmacy. When asked if insurance plans and PBMs should require patients to use more expensive brand-name medicines when there is a less expensive alternative, 83% percent answered "No."
"Being able to choose their pharmacy continues to be a patient priority," NCPA CEO B. Douglas Hoey, RPh, MBA, asserted. "Despite the pandemic having changed other consumer behaviors, they want access to a local healthcare provider who knows them and will help them find the best, most affordable treatments."
A smaller majority (60%) said that it was unfair that inadequate reimbursement sometimes means pharmacies lose money on prescriptions. As for the new COVID-19 oral antiviral medicines, half of the respondents said they think insurance companies and PBMs should reimburse pharmacies enough to cover the cost of the drug, the costs to dispense the drug, and to make a small profit. Another 32% percent agreed that the reimbursement should be enough for the pharmacy to at least cover its costs, which is about $40. More than 70% considered the $1 reimbursement sometimes seen by pharmacies as unfair.
"Patients understand that pharmacies are unlikely to be able to offer these vital therapies if miserly insurance companies hoard the patient's monthly premiums for their own corporate gain rather than acknowledging the pharmacist's extra time and coordination that goes into making sure patients are safe and get the most benefit from these potent drugs," Dr. Hoey added. "They know intuitively that access to drugs will dry up and pharmacies will close. Policymakers must acknowledge this too, and they should take action. These are important treatments that can prevent costly hospital stays and save lives, and they should be available to the patients who need and are appropriate for them."
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