Scumbags

And no, this post isn't about lawyers.

It's about folks who may be even lower.......... insurance companies.




Over the last few years, we've seen our reimbursements get cut. At on point, we were reimbursed AWP - 15% plus a $3.50 dispensing fee on generics (and that will be the focus of this brief post).

Now we're looking at MAC plus $1.50, WAC plus 1.75. Anything to decrease the insurance company's payout to the pharmacy.


One of my local insurance carriers has sunk to a new low, even for insurers.

The insurance company is owned by one of the local hospitals and covers about 40% of the local market. The hospital has several facilities around the area, which are supplied by different wholesalers. McKesson, Cardinal, AmerisourceBergen.... you name it and they are contracted with it.

Here's the genius of their scheme. They reimburse based off of the lowest price that their facilities are able to purchase medications. So if McKesson has the lowest price on generic Keppra, that's the price that the insurer will reimburse the pharmacies. If Ritchie has the best gabapentin price, that's what we get reimbursed.

This year alone my pharmacy has seen its margin from this insurer fall 35%.




And you wonder why pharmacists think that the insurance companies are evil.