Effort to amend New York drug-access law raises concerns

Approximately 700 people gathered Tuesday in Albany, New York's capital, to lobby for the Pharmacists Society of the State of New York's goals, one of which is to amend the state’s anti-mandatory mail order prescription drug law.

The Pharmacists Society and other proponents of the 2011 law, which regulates mail access to pharmaceuticals, say it is not working as intended. 

Instead of promoting community pharmacies, the law benefits pharmacy benefit managers, the society says. They favor mail-order prescription services, which cost consumers less than buying drugs in person.

The Pharmacists Society talking points charge "PBMs (pharmacy benefit managers) are an unregulated healthcare entity that operates completely outside our state's laws." They're calling for more state government regulation.

New York business associations oppose the measure unanimously.

“The use of mail-order pharmacies has driven the cost of those pharmaceuticals for the consumer down significantly,” said Lev Ginsburg, director of government affairs for the Business Council of New York State, which opposes the bill. “There are so many variables in the health care field in general that are driving costs up, that when you find one or two tools out there that have been successful, you really don’t want to backtrack.”

By taking advantage of volume discounts, mail-order pharmacies can significantly reduce costs associated with prescription drugs. Because prescription-drug coverage is optional for New York employers, this necessarily increases the number of uninsured New Yorkers. Far from ensuring access to the pharmacies of choice, the changes proposed by Assembly Bill 6194/Senate Bill 2530 would actually decrease access to pharmaceuticals for all.

Sen. Martin J. Golden (R-Brooklyn) and Assemblywoman Latoya Joyner (D-The Bronx) are the bill sponsors.

A 2011 CVS Caremark study published in the Journal of the American Pharmacists Association said that if the costs of both mail-order pharmacies and community pharmacies are kept the same for the consumer, consumers were still more likely (by a 2-to-1 margin) to order prescriptions from mail-order pharmacies. Customers voluntarily chose the mail-order pharmacies over their community counterparts without the financial incentives to do so.

The increase in prescription-drug coverage overall and the ever-increasing number of people using prescription drugs have made both mail-order and community pharmacies abundantly successful in recent years. However, by eliminating the option for the managers to steer customers toward the cheaper mail-order drugs that the study suggests they would more than likely prefer, costs would necessarily have to rise by an estimated $392 million in one year alone.

“New, more complex medicines come to the market every day, and not all drugstores are equipped to safely administer every one of them.” Charles Cote, vice president of strategic communications for the Pharmaceutical Care Management Association, said.

Cote cited a study from North Star Opinion Research that found only 5 percent of physicians believed every pharmacy could safely provide specialty medications. “Forcing plans to ignore this basic reality puts patients at risk and raises premiums," Cote said. “The only people benefiting from this kind of legislation are drugstores.”

An identical measure was considered in 2014. Assembly Bill 5723/Senate Bill 3995 was sponsored by then Assemblyman Carl Heastie (D-The Bronx) and Sen. George Maziarz (R-Niagara County). It passed the Assembly but stalled in the Senate.

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Business Council of New York State 152 Washington Avenue NY - 12210