Patients and their community pharmacists are increasingly dealing with drug shortages, according to a survey recently conducted by the National Community Pharmacists Association (NCPA). The survey also indicates that health insurance plans and/or pharmacy benefit managers (PBMs) could better address problems brought on by the shortages by expanding coverage to pay for alternative therapies and adjusting reimbursement rates to keep pace with market price increases.
While the problems surrounding drug shortages in hospital settings are well-publicized, similar issues affecting community pharmacies are less known. Today a House subcommittee is holding a hearing regarding drug shortages today. (NCPA submitted a statement to the subcommittee presenting pharmacists’ views.)
NCPA recently surveyed 675 community pharmacists regarding drug shortages. Responding pharmacists indicated that the drug shortage has resulted in an inability to fill prescriptions, higher acquisition costs, and lack of insurance coverage for alternative drugs, all of which ultimately may result in the patient going without their necessary medications.
Among the survey’s key findings:
- 96 percent of responding pharmacists experienced a drug shortage in the past six months.
- 82 percent have been experiencing drug shortages at least daily (59 percent) or weekly (23 percent).
- 80 percent said that the average shortage last three weeks or longer.
- 78 percent indicated that patients have to go without taking their medication(s) due to shortages, suggesting that patients are unable to obtain their needed supply from alternative pharmacies, either.
- 81 percent observed price fluctuations resulting in higher drug acquisition costs. However, 62 percent noted that health plan/PBM reimbursements were not effectively updated to reflect acquisition cost increases. For example, one pharmacist cited the shortage problem in a number of recent prescriptions on which the pharmacy lost $20 to $150 per prescription.
- 52 percent said that insurance companies/PBMs do not cover alternative therapy when the prescribed drug is not available. In those cases, the patient is burdened with the paying out-of-pocket.
The pharmacists’ concern centers mostly on the availability of Adderall and its generic equivalents used for attention-deficit hyperactivity disorder (ADHD). Topical creams and ointments were also cited.
Food and Drug Administration (FDA) figures indicate that the number of reported prescription drug shortages has nearly tripled between 2005 and 2010, going from 61 to 178.
NCPA continues to work constructively with Congress on legislative solutions. The pharmacy payment issues exacerbated by these shortages further validate the need for provisions included in The Pharmacy Competition and Consumer Choice Act (S.1058/H.R.1971) relating to updating reimbursement rates for community pharmacies to reflect market changes in drug cost.