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APhA urges insurers, PBMs to remove barriers on Rx refills for COVD-19 preparedness

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WASHINGTON — The American Pharmacists Association (APhA) is calling on all of the nation’s health insurers and pharmaceutical benefit managers (PBMs) to immediately remove/waive any administrative barriers on pharmacists and patients for access to early medication refills to ensure patients have the medications necessary for chronic diseases to address their needs during the ongoing coronavirus pandemic.

APhA supports the steps already taken by some states and payers authorizing pharmacists to dispense emergency refills or waiving early medication refill limits on 30-day prescription maintenance medications, and the guidance in this area issued by the Centers for Disease Control and Prevention (CDC) and Department of Homeland Security.

“It’s essential that patients be prepared and have adequate supplies of their prescription medications,” said APhA senior vice president, Pharmacy Practice and Government Affairs, Ilisa Bernstein. “America’s pharmacists can best serve patients if barriers to access medications, such as not allowing early refills, burdensome prior authorization, refill limits, and home delivery requirements are removed now, not later.”

Without immediate changes to implement broad, system-wide authorization for early or emergency refills for chronic medications, patients may have to endure long waits at the pharmacy while the pharmacist addresses the administrative barriers. Not only does this frustrate patients, but it challenges pharmacists’ ability to deliver patient care services.

APhA also strongly supports the recent actions taken by the Centers for Medicare and Medicaid Services (CMS) reminding Medicare Advantage and Part D plans of their ability to:

  • remove prior authorizations requirements,
  • waive prescription refill limits, and
  • relax the restrictions on home or mail delivery of prescription drugs.

APhA has previously recommended that patients and/or caregivers check their prescription benefit coverage with their health insurance and/or PBM to determine coverage for early refill or supply limits before requesting refills from their pharmacy.


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