The Association of Community Pharmacists (ACP) estimates that Medicare Part D's payment structure was responsible for >1000 closings of independent pharmacies nationwide in 2006. Community and independent pharmacists claim that Part D has given pharmacy benefit managers (PBMs) power to set low reimbursement rates to pharmacies.
Pharmacy officials in Maryland and Virginia do not have concrete data on the number of independent-pharmacy closures. Several rural pharmacies, however, either sold out to a larger retail store or closed as a result of the drug benefit. Crystal Wright, spokeswoman for the ACP, said that independents have little choice but to take the PBMs' reimbursement rates.
Susan Hayes, principal of Pharmacy Outcomes Specialists, argues that community pharmacies are not going under because of the PBMs' reimbursement rates. Instead, they are closing due to the increased burden Part D has placed on them.
One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
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