Brand-name drugs are becoming increasingly scarce from Harlem to Hollis, Queens thanks to abusive practices by middlemen known as pharmacy benefit managers (PBMs), and independent pharmacists are sounding the alarm.
According to a survey of 161 independent pharmacies released today by the New York City Pharmacists Society, 89 percent of respondents have been forced to turn away patients since January 1st due to underwater reimbursements, resulting from massive fees imposed by PBMs that threaten to put independent pharmacies out of business.
A full 98 percent of respondents reported they’ve stopped carrying some or all brand name drugs since January 1st in or to avoid sustaining crippling losses on those medications.
Independent pharmacies blame pharmacy benefit managers (PBMs), a group of Fortune 15 corporations that have amassed enormous power in recent years as controversial middlemen between insurers, patients, drug makers and pharmacies. PBMs have long imposed onerous fees on pharmacies – leading hundreds of NYC pharmacies to reduce store hours, lay off employees, or close their doors – but a January 1st rule change provides new transparency into those fees.
Pharmacies regularly lose $30 to $100 – and often as much as $250 or more – every time they fill a prescription for a wide range of common brand name drugs. Respondents to the survey – which was conducted in February and March – most frequently cited Biktarvy, Eliquis, Entresto, Farxiga, Humira, Januvia, Jardiance, Mounjaro, Ozempic, Symbicort, Trulicity, Wegovy, and Xarelto among those they have stopped carrying.
Previously, PBMs clawed back feesretroactively in one lump sum on a quarterly basis, leaving pharmacists unable to determine how much they were losing on any particular prescription. As of January 1st, pharmacists now can see at the point of sale how much they will lose on a prescription.
“Our health care system is broken, and powerful pharmacy benefit managers are at the heart of the problem –pushing drug prices higher, eliminating patient choice, ripping off taxpayers, and destroying neighborhood pharmacies,” said Tom Corsillo, a spokesperson for the New York City Pharmacists Society. “The findings of this survey demonstrate the devastating impact abusive PBM practices are having on vulnerable patients across New York City and the need for policy makers to act with urgency to intervene.”
Independent pharmacists are urging New Yorkers to voice their concerns with the New York State Department of Financial Services’ Pharmacy Benefits Bureau – which was established in 2022 by Governor Hochul to license, regulate, and monitor the activities of PBMs – by visiting PBMhorrostories.com.
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