A bill headed for New York Gov. Kathy Hochul\u2019s desk would provide a boost to pharmacies across the state, but critics fear it could lead to higher prices for consumers.<\/p>\n
The state Legislature passed a measure earlier this month that would require pharmacy benefit managers to pay a roughly $10-per-prescription dispensing fee and standardize the price they pay to pharmacies for particular drugs.<\/p>\n
Benefit managers act as middlemen that negotiate with pharmacies, insurers and drug manufacturers. They\u2019re in charge of negotiating rebates with drug makers and processing claims from pharmacies.<\/p>\n
The bill is designed to shift money from those benefit managers to the pharmacies themselves and assist independent pharmacies that are in competition with major conglomerates like CVS, which owns one of the big three benefit managers.<\/p>\n
But benefit managers and health insurers are urging Hochul to veto the bill. They warn the measure will force New Yorkers to pay more for their drugs and insurance premiums at a time when many public officials, including Hochul, are emphasizing issues of affordability.<\/p>\n
\u201c\u200aIt\u2019s going to result in hundreds of millions of dollars in new costs that will have to be built into premiums, which means employers and consumers will pay those costs,\u201d said Eric Linzer, president of the New York Health Plan Association, which represents private insurers.<\/p>\n
Independent pharmacies have been pushing for the changes for years, arguing that the current system allows benefit managers, known as PBMs, to profit at their expense.<\/p>\n
\u200aParthiv Shah, president of the state Pharmacists Society, said pharmacies are sometimes reimbursed by benefit managers at rates lower than what it actually costs them to fill a prescription.<\/p>\n
\u2018[Pharmacies] are being asked to do more for patients while being paid less than it costs to provide that care,\u201d he said at a news conference at the state Capitol earlier this year. \u201cAnd who’s profiting? The PBMs. Billions of dollars.\u201d<\/p>\n
The Pharmaceutical Care Management Association, which represents an array of benefit managers including giants CVS and Express Scripts, says the bill would have a major cost.<\/p>\n
Johnny Garcia, the association\u2019s assistant vice president of policy, said the group estimates it would add $576 million in costs. The average dispensing fee now is about $2, he said, far less than the roughly $10 fee required in the bill.<\/p>\n
\u200a\u201dIt\u2019s a bad bill because it’s a prescription tax, basically,\u201d Garcia said.<\/p>\n