The new Medicare Part D benefit for seniors has altered the community pharmacy reimbursement structures dramatically, forcing cash and dual-eligible Medicaid patients into less profitable, private third-party-payer programs. This research is designed to assess the potential financial implications for community pharmacy and for community health care in general. This is a proposal for a quantitative research project that will interview a convenience sample of 12-15 community pharmacies to assess the impact of Medicare Part D on pharmacy margins using the first 6 months of 2006 data. This data will be compared with historical 2005 data from the same pharmacies to determine any changes in gross margins. Using changes in gross margins coupled with patient payer mix information, we can estimate the effects of any changes in gross margins on overall pharmacy profitability. Information from existing sources regarding cost to dispense and pharmacy margins will be used to make those estimations. This timely information could be used to better understand the effects of Medicare Part D on their business model and to inform those outside community pharmacy as to the potential effects on patient access and quality of care.
R.Ph., MBA, CDE
Black Diamond Pharmacy, LLC