Pharmacists say PBMs are holding up Tamiflu supply

The National Community Pharmacists Association (NCPA) is taking pharmacy benefit managers to the woodshed, upset with policies that seem to hold up claims for materials needed to create the liquid form of flu-fighter drug Tamiflu. According to the association, PBMs are making it much harder to compound the materials needed to help H1N1 flu victims.

Given the unusual demand for the drug created by the H1N1 virus pandemic, Tamiflu maker Roche has asked pharmacists to compound the liquid form of the drug until supplies increase. That itself creates a significant amount of work for pharmacists, including the NCPA's 22,700 independent community pharmacies.

PBMs are making this process even harder, the NCPA says. In some cases, PBMs aren't processing claims for compounds promptly, and some are requiring prior authorizations, which take 24 to 72 hours to obtain.

In an effort to solve the problem, the trade group has sent letters to Express Scripts, CVS Caremark and Medco Health Solutions asking these large PBMs to relax their policies on compounded medicine during the flu outbreak.

To get more detail on this issue:
- read this St. Louis Business Journal piece

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