By NextBestFitFair dispensing fees and support for rural pharmacies
Pay pharmacies a transparent dispensing fee covering costs, with extra payments in underserved areas.
Transparent dispensing fees keep pharmacies open.
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This path
Fair dispensing fees and support for rural pharmacies
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Set a transparent dispensing fee covering costs
- Add rural pharmacy payments
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Pharmacy closures and pharmacy deserts
Transparent dispensing fees covering costs, with extra payments in underserved areas, help rural and independent pharmacies stay open and replace opaque pharmacy benefit manager reimbursement.
What it creates or worsens
- Raises spending or loosens control over it
Cost-covering dispensing fees and additional underserved-area payments raise dispensing costs.
- Adds paperwork, coordination, or complexity
Cost-covering dispensing fees require regular updates to fee levels.
Who's affected
Who gains
- Rural residents
- Pharmacy closures and pharmacy deserts: Pharmacy closures reduce access to medicines, especially without transportation.
- Older adults
- Pharmacy closures and pharmacy deserts: Pharmacy closures reduce access to medicines, especially without transportation.
- Community pharmacies
- Pharmacy closures and pharmacy deserts: Transparent dispensing fees covering costs, with extra payments in underserved areas, help rural and independent pharmacies stay open and replace opaque pharmacy benefit manager reimbursement.
Who loses
- Pharmacy benefit managers and their pharmacies
- Pharmacy closures and pharmacy deserts: Affiliated mail and specialty pharmacies benefit as local pharmacies close.
- Taxpayers and public budgets
- Raises spending or loosens control over it: Public budgets pay the added spending.
Where it has been tried
- Canadian provinces: Set dispensing fees publicly.
- Ontario, Canada: In 2021–2022, Ontario's public drug plan had a standard dispensing fee of C$8.83 per prescription, with higher fees up to C$13.25 for rural pharmacies; long-term care residents were covered by a separate capitation model.