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Legislation would restore choice of providers

My father owned a community pharmacy in a small town for 25 years. For all those years, he faced competition from many sources.

But even with all the competition, my father believed that you will thrive if you take care of your customers.

What my father did worry about were factors he couldn't control -- increased taxes and regulations, lowered reimbursement from Medicaid and insurers, or a local employer mandating that its employees purchase prescription drugs through an out-of-state mail-order company.

That has occurred repeatedly recently as pharmacy benefits managers (PBMs) exert increasing control over the multibillion-dollar prescription drug market with claims they provide drugs more cheaply. But PBMs don't want to let the market test those claims in the light of day. They rebuff all calls for transparency even as they insist on mandatory mail-order rules for insurers that sign up with their plan.

Now state legislators, with State Sen. George Maziarz, R-Newfane, leading the way, have overwhelmingly approved a bill to ban mandatory mail-order plans and restore consumer choice and competition. No one would be forced to give up mail order if that is his choice. Local pharmacies, whether independents or chains, would have to match insurance plans' cost and co-pay provisions to take part.

Contrary to dire warnings the PBMs have unleashed through a new group called Citizens Against the Prescription Drug Tax, there is no tax. There are no additional costs to consumers or health insurers, whether companies buy insurance or sell it. All the bill does is give patients options to deal with a live pharmacist now rather than wait for prescriptions through the mail.

The PBMs even make the Alice in Wonderland argument that introducing more competition into the prescription drug business is anti-competitive. It is Economics 101 that increased competition lowers costs, not raises them.

That hasn't stopped the PBMs from warning that allowing a level playing field somehow gives independent pharmacists an unfair competitive edge. Frankly, I believe it is an anti-competitive conflict of interest for the PBMs to design pharmacy benefit plans and also own the mail-order company that benefits from the plan, which is the case with several large mail-order houses.

There is no right for independent pharmacies to survive any more than any other small business. But I also believe that it is not in New York State's best interest to send thousands of jobs and billions of untaxed dollars out of state and block local, taxpaying small businesses from a fair shot.

The PBMs know mail-order houses cannot match local pharmacists in service, and they are afraid to let them show that they can match or beat their prices for prescriptions.

Gov. Andrew M. Cuomo should sign this bill and let the market decide.


Jack Koford is director of Experiential Education at the D'Youville College School of Pharmacy.

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