PART D IS BLAMED FOR PHARMACY CLOSURES

The Associationof CommunityPharmacists(ACP) estimates that MedicarePart D's payment structurewas responsible for >1000 closings ofindependent pharmacies nationwide in2006. Community and independentpharmacists claim that Part D has givenpharmacy benefit managers (PBMs)power to set low reimbursement ratesto pharmacies.

Pharmacy officials in Maryland andVirginia do not have concrete data onthe number of independent-pharmacyclosures. Several rural pharmacies,however, either sold out to a largerretail store or closed as a result of thedrug benefit. Crystal Wright, spokeswomanfor the ACP, said that independentshave little choice but to take thePBMs' reimbursement rates.

Susan Hayes, principal of PharmacyOutcomes Specialists, argues that communitypharmacies are not going underbecause of the PBMs' reimbursementrates. Instead, they are closing due tothe increased burden Part D has placedon them.