STAT+: Pharmacies fear New Year’s financial squeeze from Biden administration rule
Under a new policy, there will be a period when pharmacies are being billed PBM fees from 2023, and 2024 bills are piling up at the same time.
WASHINGTON — The Biden administration seemed to be giving pharmacies a win when they forced pharmacy benefit managers to be more up-front about the behind-the-scenes fees they charge.
But now pharmacies are afraid the transition to the new system on Jan. 1 will lead to a cash flow crunch.
In the past, PBMs could charge pharmacies performance-based fees long after the fact, and the total amount of the fees has grown in recent years. But now, PBMs will have to charge the fees up front. The administration expects that some patients could see lower costs at the pharmacy counter following the change, while PBMs counter that Medicare premiums could increase.
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