By John Kaliabakos
Pharmacist, village apothecary
On March 18, 2022, more than 100 independent New York City pharmacists and their patients protested outside Governor Hochul’s office in Manhattan, saying their financial needs were being overlooked as Albany finalized the state budget.
The protest follows news that the NFL Buffalo Bills will receive nearly $1 billion in taxpayer dollars to fund a new stadium, while pharmacists who have fought and sacrificed to stay open and keep their patients in good health for more than two years of the pandemic are apparently expendable.
Independent pharmacies face permanent closure in the coming weeks unless Albany enacts S7909/A9165, a “fee-pay” law sponsored by Sen. James Skoufis in the Senate and Assemblyman Richard Gottfried in the Assembly, requiring prescription drug intermediaries known as “PBMs” (pharmacy benefit managers) who administer the state’s Medicaid Managed Care program to fairly reimburse pharmacies for the drugs they dispense. Currently, PBM-controlled models reimburse pharmacies at or below cost for the overwhelming majority of prescriptions. Thus, pharmacies operate at a loss for a large part of the prescriptions. A service fee law would ensure that pharmacies are reimbursed the price of the drugs plus a reasonable dispensing fee for the prescriptions they fill.
Pharmacists made fee-for-service parity the centerpiece of the bipartisan pharmacy bailout program passed unanimously by the Senate and Assembly in June 2021. In late 2021, Governor Kathy Hochul signed into law keys to the pharmacy bailout program and has pledged to address service fee parity as part of the 2022 state budget negotiations. At this point, Governor Hochul plans to use taxpayer dollars to finance a stadium contract, but it did not address this key question concerning the reimbursement of pharmacies.
Independent New York pharmacies are losing money on nearly half of the prescriptions they fill, according to a 2019 analysis of Medicaid prescription drug claims by 3 Axis Advisors. A 2019 survey by the Senate Committee on Government Investigations and Operations, chaired by State Senator Skoufis, found that PBMs reduced reimbursements, “forcing many rural and independent pharmacies to permanently close their doors.” A March 2021 survey of more than 300 independent pharmacies – conducted by the Pharmacists Society of the State of New York (PSSNY) found that 98% of respondents had seen their reimbursements further reduced during the pandemic, and 97% were worried about having to lay off employees, reduce opening hours or close stores because of these reductions. In fact, a few pharmacies have already been forced to close in our West Village neighborhood.
For the past two years, pharmacists have been on the front lines of the pandemic, ensuring patients continue to receive the medications they need, despite many doctors’ offices being closed or hard to reach. Additionally, many pharmacists were engaged in administering COVID tests and later COVID vaccines in addition to their regular operational duties. New York City in particular has also faced a crime wave where pharmacies have been reeling from excessive shoplifting and looting. The pandemic has also wreaked havoc on supply chains and pharmacies have also felt the brunt of this issue. These issues, coupled with unfair reimbursement rates, have not only had a devastating financial impact on New York City pharmacies, but also on equitable patient access to healthcare. Low-income New Yorkers are, as always, the biggest victims of this situation.
“It is unconscionable that the state has chosen to distribute hard-earned taxpayer dollars to the owner of the Buffalo Bills, instead of investing in essential healthcare workers, patients and access to care,” said Dr. Karl Williams, president of the Pharmacists Society. of New York State. “While independent pharmacists are losing money every day and fighting to keep their place in our communities to continue to serve vulnerable patients, those who grossly enrich themselves on the backs of taxpayers are cracking down. Governor Hochul must keep her word and enact fee-for-service in the final state budget. »