"Review of the Relationship Between Medicare Part D Payments to Local, Community Pharmacies and the Pharmacies’ Drug Acquisition Costs," (A-06-07-00107)
January 3, 2008
Complete Text of Report is available in PDF format (971 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.
EXECUTIVE SUMMARY:
We conducted this review at the request of 33 Senators.
Medicare Part D payments, excluding dispensing fees, to local, community
pharmacies exceeded the pharmacies’ drug acquisition costs by an estimated 18.1
percent when the analysis included rebates that drug wholesalers paid to
pharmacies. Excluding rebates, Part D payments exceeded drug acquisition costs
by an estimated 17.3 percent. The estimated difference between Part D payments
and drug acquisition costs was $9.13 per prescription including rebates and
$8.78 excluding rebates.
The estimated average Medicare Part D dispensing fee paid to local, community
pharmacies was $2.27 per prescription, about $2 less than the average Medicaid
dispensing fee. We recommended that Congress and CMS consider the results of
our review, including the data provided, in any deliberations regarding Medicare
Part D reimbursement. CMS concurred with the recommendation.