The Globe and Mail reports in its Wednesday edition that some patients who take the popular weight-loss drug Wegovy, made by Novo Nordisk, are having their prescriptions redirected to pharmacies that have signed exclusive deals with their group benefit insurers, an industry practice called preferred pharmacy networks or PPNs. The Globe's Chris Hannay and Clare O'Hara write that pharmacists in both Alberta and Ontario highlighted multiple incidents where drug claims for Wegovy have been rejected by insurance companies for reimbursement under group benefit plans. In most cases, pop-up messages at pharmacy checkouts alert patients that they have to contact a preferred pharmacy in order to receive their medication. Insurers create PPNs to maintain service standards and control costs for plan sponsors by negotiating lower pharmacy markups and fees. Pharmacies -- particularly independent ones left out of networks -- argue the exclusivity deals reduce patient autonomy and can leave patients filling prescriptions at multiple different pharmacies, depending on how the PPNs treat each drug. The Ontario government recently proposed options to regulate PPNs and has carried out two public consultations in the past year.
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