Rx for failure

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DECATUR, Ill. (WAND) – Independent pharmacists are hoping state lawmakers can come up with a remedy to the new medicaid managed care program which pharmacy owners say could put them out of business.

Pharmacists are telling lawmakers the combination of the managed care program and Pharmacy Benefit Managers (PBMs) are causing them to barely break even, or lose money, on every Medicaid prescription they fill.  PBMs are the middle man between insurance companies and pharmacies.  They set the prices for how much drug stores can charge for each prescription.  Some lawmakers say it may require legislation to stop the bleeding.

“Since July of 2017 we know of at least 18 pharmacies in the state of Illinois that have had to either sell out to CVS, or a different retailer, or just shutdown altogether,” Lauren Young of Dale’s Southlake Pharmacy in Decatur told WAND’s Doug Wolfe.  “We’re not able to effectively take care of the customer because the state set it up to fail.”

Dale Colee, owner of Dale’s Southlake Pharmacy, agrees with Young’s assessment.

“We’re getting paid virtually next to nothing for the prescriptions and the state of Illinois is paying a lot of money for those prescriptions,” Colee said.  “You’re not going to see a lot of the pharmacies that are here in Illinois, right now.”

State Senators Andy Manar, (D) Bunker Hill and Sam McCann, (R) Plainview, are working on legislation to fix prescription pricing in the managed care program.  A similar measure was approved by the Illinois House last week. 

(Tomorrow a look at individual pharmacists and how PBMs are impacting their business.)

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