Part 2: Gift Shops, Pet Meds Make Up Costs Of PBM Contracts

SALISBURY, Md. - Local pharmacies say they're losing money when they sell prescriptions at least five percent of the time.

So how are they making that money up?

One of those creative ways: by filling specialty medications for patients, even prescriptions for pets.     

Apple Discount Drugs owner Jeff Sherr says the model for community pharmacies is changing. The store is consulting patients, also offering classes for people diagnosed with diabetes.

"We're losing money in some areas, but we're not losing money overall," said Sherr. "If we can keep them out of the hospital, we're doing a good job keeping them healthy."

Over at Pemberton Pharmacy, owner Craig Schury says the gift shop helps make up for some of the his stores losses from PBM-contracted prescriptions.
"Other prescriptions, we may make money, a good amount of money on certain ones, but as it comes across the board, we are losing money on 10 percent of prescriptions," said Schury.

Those losses multiple pharmacists tell WMDT come from "binding contracts." In one instance, Sherr shows WMDT one drug increased nearly 3,500 percent from the original buying price.

Sherr says the change can take at least one month before the pharmacy benefit manager recognizes the change. Sometimes the change is never recognized, Sherr says.

"The PBMs are not raising the prices with their reimbursement," said Sherr. "The drug goes up in price, we buy it from the wholesaler. We're paying a higher price, but the people that are paying us are basing that off of the price before the increase.

"The longer that they drag their feet the more profitable it becomes for them. You can't pay me $60 for something that cost me $166. We call the PBM and they say 'they're looking into it.'"

As a comparison, WMDT reached out to several restaurants to ask, "if they would lose money on about 5 percent of their items, what would they do?"

Owners said they wouldn't even sell that item. But if they were bound by a contract, they would probably have to close their doors.

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