Nonprofit pharmacy in Penn Hills struggles to survive after $26,000 ‘unexplained’ fee

PENN HILLS, Pa. — A Penn Hills nonprofit founded by Sean and Shannon Parsons in 2016, the Lost and Found Pharmacy, helps customers to save money and their lives.

“Cancer drugs that were going to cost them over $3,000 each through their insurance. Just us simply giving it to them at our cost, we were able to get each of them taken care of for $107,” Sean Parsons said.

Parsons said the pharmacy is able to offer reduced medication costs through a Patient Care fund, soda fountain sales, and the support of their community. But now, a massive financial blow at the hands of Express Scripts, its pharmacy benefit manager: a manual adjustment of more than $26,000 on a 2022 Statement of Claims the pharmacy said it just received, and Parsons said no one from Express Scripts can tell him what it’s for.

“They didn’t give us any explanation as to where it was, how they came to it,” Parsons said, “It almost feels like a terminal diagnosis we’ve been hit with, where suddenly, out of nowhere, they just sit there and say, ‘Oh, you have this.’”

With the fee jeopardizing their ability to carry on, the Lost and Found Pharmacy created a GoFundMe page, hoping it would help to keep them afloat and give their customers a fighting chance.

“We work on very thin margins here, trying to do everything we can to help people. Then, taking back that money like that, that makes it very hard to get more medications in to even have on the shelf,” Parsons said.

Express Scripts provided the following statement to Channel 11:

“We are committed to paying all pharmacies - from large chain pharmacies to independent community pharmacies - fairly. To ensure that patients receive their medications safely and affordably, some Medicare Part D plans choose to adopt networks that vary reimbursement based upon the pharmacy’s performance against certain metrics. As agreed to in their contract, if the pharmacy does not meet these metrics, then they may be required to pay back a percentage of the fees they have received over the course of the year. We have reached out directly to this pharmacy to provide them with additional information and guidance on their performance.”

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