Staggering Amount of Pharmacies Report Underpayments for Tamiflu


Access to Tamiflu and generic oseltamivir are critical for combatting rampant influenza infections.

Independent pharmacists face yet another challenge associated with the 2017/2018 influenza season: A recent survey administered by the National Community Pharmacists Association (NCPA) revealed that pharmacy benefit managers may be underpaying pharmacies for Tamiflu or generic oseltamivir.

The NCPA stated that this underpayment leaves pharmacies in jeopardy as they continue to dispense the flu medication.

The findings showed that 88% of independent pharmacy owners who responded to the survey have experienced numerous cases of reimbursement for Tamiflu or oseltamivir that fell below their acquisition costs.

"Many PBM contracts require pharmacists to dispense to a patient a medication they have in stock, regardless of whether it is at a loss," said NCPA CEO B. Douglas Hoey, RPh, MBA, in a press release. "As a result, many community pharmacies are having to eat the loss in order to see that their patients are cared for during one of the worst flu seasons in years. Some respondents are citing losses in excess of $60, even $70 per prescription.”

As new cases of the flu continue to boom, access to these treatments is crucial to prevent the infection from spreading at pandemic levels. Dispensing these drugs to countless patients may cause pharmacies to experience serious hardships, according to a press release.

NCPA questions the motives of pharmacy benefit managers (PBMs) who are accused of underpaying independent pharmacies for flu drugs.

"One could ask, are PBMs profiteering off independent pharmacies in the midst of a national flu epidemic? Underpaying pharmacists that are trying to help their sick patients is shameful behavior," Hoey said. "Yet underpayments like this happen to independent pharmacies on a range of different medications every day. It's representative of the way PBMs are making money at the expense of community pharmacies.”

The NCPA survey also showed that many pharmacy owners reported having trouble acquiring Tamiflu and oseltamivir as capsules or a suspension within the past 60 days, as the flu season peaks.

"Moreover, it's entirely possible that while PBMs are squeezing independent pharmacies on Tamiflu and many, many other medications, they may be billing the plan sponsor a much higher price than they reimbursed the pharmacy, and pocketing that excessive spread. In many instances when that is the case, the plan sponsor is none the wiser,” Hoey said.

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