By John Kaliabakos
Pharmacist, Village Apothecary
On March 18, 2022 more than 100 of New York’s independent pharmacists and their patients protested outside of Governor Hochul’s Manhattan office asserting that their financial needs are being neglected as Albany finalizes the state budget.
The protest comes on the heels of news that the NFL Buffalo Bills will receive nearly $1 billion taxpayer dollars to fund a new stadium, while pharmacists who have struggled and sacrificed to stay open and keep their patients healthy for over two years of the pandemic are apparently expendable.
Independent pharmacies are in jeopardy of permanently closing in the coming weeks unless Albany enacts legislation S7909/A9165, a “Fee-for Service” law sponsored by Senator James Skoufis in the Senate and Assemblyman Richard Gottfried in the Assembly, requiring prescription drug middlemen known as “PBMs” (pharmacy benefits managers) operating the state’s Medicaid Managed Care program to reimburse pharmacies fairly for the drugs they dispense. Currently, PBM controlled models reimburse pharmacies at or below cost for an overwhelming majority of prescriptions. As such, pharmacies operate at a loss for a large percentage of prescriptions. A fee for service law would ensure that pharmacies are reimbursed at the cost of drugs plus a reasonable dispensing fee for the prescriptions they fill.
Pharmacists made Fee-for-Service Parity the centerpiece of the bipartisan Pharmacy Rescue Package that passed unanimously by the Senate and Assembly in June 2021. At the end of 2021, Governor Kathy Hochul signed into law key elements of the Pharmacy Rescue Package and committed to addressing Fee-for-Service Parity as part of the 2022 state budget negotiations. At this point Governor Hochul is planning to use taxpayer dollars to fund a stadium deal but she has not addressed this key issue regarding pharmacy reimbursement.
New York’s independent pharmacies lose money on nearly half the prescriptions they fill according to a 2019 analysis of Medicaid prescription drug claims by 3 Axis Advisors. A 2019 investigation by the Senate Committee on Investigations and Government Operations, which State Senator Skoufis chairs, found PBMs were reducing 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 their reimbursements further cut during the pandemic, and 97% feared they will have to lay off employees, reduce store hours or close as a result of those cuts. In fact, a few pharmacies have already been forced to close in our area of the West Village.
For the last two years pharmacists have been on the frontlines of the pandemic, ensuring that patients continue to receive the medications they need, despite the fact that many physician’s offices were closed or difficult to contact. Additionally, many pharmacists were engaged in administering COVID tests and later COVID vaccines on top of their regular operating duties. New York City in particular has also been dealing with a crime wave where pharmacies have been left reeling from excessive shoplifting and looting. The pandemic has also wreaked havoc on supply chains and pharmacies have felt the brunt of this problem as well. These issues coupled with the unfair reimbursement rates have not only had a devastating financial impact on pharmacies in New York City but also on equitable patient access to health care. Low income New Yorkers as always are the greatest victims of this situation.
“It’s unconscionable that the state has chosen to hand out 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 the State of New York. “While independent pharmacists are losing money every day and fighting to keep their place in our communities to continue serving vulnerable patients, those grossly enriching themselves on the backs of taxpayers run rampant. Governor Hochul must keep her word and enact Fee-for-Service in the state’s final budget.”