UPMC Health Plan reducing ACA pharmacy network by 60%

UPMC Health Plan is adding a preferred pharmacy network to its ACA plans, reducing the number of pharmacies available to members by 60 percent, The Pittsburgh Post-Gazette reported Jan. 5. 

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The payer said around 15 percent of its 114,000 ACA members will have to switch pharmacies. 

Chronis Manolis, chief pharmacy officer for UPMC Health Plan, told the outlet networks are a “powerful lever” to manage prescription drug spending. UPMC has used pharmacy networks in its Medicare Advantage plan since 2019. 

Mr. Manolis told the newspaper large suppliers Walgreens and CVS are not part of the preferred network, to make room for smaller, independent pharmacies. 

Independent pharmacists told the Post-Gazette UPMC’s network changes, and similar moves from other payers, threaten small pharmacies’ ability to stay in business. 

Read more here.

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