Written and medically reviewed by Dorcas Morak, PharmD
Despite the widespread demand for Ozempic, some pharmacists in the United States have encountered difficulties in obtaining the medication, while others have made the conscious decision not to stock it. The factors influencing their actions mainly revolve around the cost of the drug and its negative impact on their businesses.For example, Nate Hux, owner of Pickerington Pharmacy in Ohio, highlighted that the average wholesale price for a 30-day supply of Ozempic is approximately $900. However, he mentioned receiving only $860 in reimbursement for each prescription. Consequently, stocking the medication became financially burdensome for his pharmacy. Hux is part of a group of independent pharmacists who have chosen to discontinue carrying Ozempic and similar drugs within the same class. One of the reasons driving their decision is the need for fairer payments from pharmacy benefits managers, who act as intermediaries between pharmacists and insurers. Another pharmacist-owner in Texas also ceased stocking Ozempic and similar diabetes medications due to consistent reimbursements that were $10 to $40 lower than the cost of the drugs.
The decision of some pharmacists not to stock these medications adds a new dimension to the ongoing Ozempic situation in the United States, where patients have already faced challenges in accessing the drug due to shortages. While supply issues contribute to the problem, many independent pharmacists have had to inform patients that they cannot provide the medication due to the inability to dispense it at a cost below its actual value.
Impact on Independent Pharmacies
Underpayments pose a significant challenge for independent pharmacists, as they often receive lower reimbursement rates compared to larger retail pharmacy chains with more negotiating power. This issue has unfortunately led to the closure of numerous independent pharmacies. Pharmacists face limited options in addressing this problem as they often encounter "take it or leave it" contracts that offer minimal room for negotiation.
Manufacturer's Response to Pharmacists' Decisions
Novo Nordisk, the manufacturer of Ozempic, has stated that they do not have control over the pricing arrangements between pharmacies and pharmacy benefit managers, or the reimbursement rates. Pharmacy benefit managers are associated with major health insurance providers, which may indicate a potential incentive to underpay pharmacists as it can drive customers to their own businesses.
Underpayment and Brand-Name Drugs
Underpayments are not exclusive to medications like Ozempic; it is a broader issue affecting brand-name drugs. Pharmacy benefit managers offer reimbursement rates to encourage pharmacists to opt for the lowest-priced drugs, which is typically not an issue with generic drugs available at lower costs. However, finding affordable prices for brand-name drugs is more challenging because a single manufacturer sets the price, leaving little room for negotiation.
Impact on Customer Trust
Although the decision not to stock Ozempic and other expensive brand-name drugs may result in the loss of some customers, some pharmacists believe it is a necessary choice to prevent their businesses from failing. While this may impact customer trust to some extent, it is a measure taken to sustain their operations. This situation highlights the challenges faced by independent pharmacies and the broader issues surrounding underpayment of brand-name drugs.
