The Knesset Health Committee has authorized for its first reading a law that would allow members of any health maintenance organization (Kupat Cholim) to fill prescriptions written by doctors at any pharmacy in the country. Prescriptions will be given at the same discount as it would at an in-network HMO pharmacy.
Some 80 to 100 million prescriptions are written in Israel each year for members of the HMOs. Currently, each HMO affiliates with independent pharmacies, which arrange to provide medicines at the discount HMO members are eligible for, with the HMO compensating the pharmacy for its costs, and the customer paying the discounted price (usually about $4). Customers who try to fulfill prescriptions at out-of-network pharmacies generally pay full price, and arrange to get compensation from their HMO themselves.
The new law will allow customers to pay the discounted rate at any pharmacy, with all pharmacies receiving compensation from all HMOs.
According to MK Oded Forer (Yesh Atid), author of the law, “in the past private pharmacies were contractually connected to all HMOs, and customers could decide on their own where to order their prescriptions. In recent years, the HMOs decided to cancel some of those agreements, essentially requiring customers to purchase prescriptions from their own networks. As a result, many small, independent pharmacies that for generations have faithfully served the public are being forced to close.
“In recent months the HMOs have been automatically sending the prescriptions to their pharmacies via messaging, so the customer no longer has any choice in where to fulfill their prescription,” he added. “This law will restore that freedom of choice.”
The Israel Pharmacists Association gave its approval for the bill, saying that “for years, we have been fighting for the elementary right of customers to utilize the services of the most convenient pharmacies, without any unnecessary restrictions.”