NYC pharmacists say they aren’t being reimbursed fairly

A recent survey showed that a large majority of neighborhood pharmacies in New York City fear for the future of their business due to the practices of pharmacy benefit managers, or PBMs.

News 12 Staff

Jan 31, 2019, 10:41 PM

Updated 1,992 days ago

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A recent survey showed that a large majority of neighborhood pharmacies in New York City fear for the future of their business due to the practices of pharmacy benefit managers, or PBMs.
PBMs are pharmaceutical middlemen who negotiate drug prices with manufacturers and decide how much money pharmacies will be reimbursed.
News 12 was at Mt. Carmel Pharmacy in Belmont Thursday where co-owner Roger Paganelli says there's little oversight and that they're often taken advantage of.
"You come in, get a prescription, I process it. I have a contract with your pharmacy benefit manager company to fill that claim. If I get reimbursed less than my total cost on that, I am obliged, contractually, to dispense that medicine to you," he explained to News 12.
Paganelli says the pharmacy lays out the money and the drugs, and they don’t always see a reimbursement.
A recent survey by the NYC Pharmacists Society looked at more than 500 neighborhood pharmacies in New York City. It found that 99 percent of owners are concerned that abusive PBM practices will jeopardize their business. It also said that 92 percent are considering reducing hours or laying off employees.
Pharmacists, like Paganelli, are calling for more regulation when it comes to PBM practices.
"We'd like to see the government step up and investigate immediately," he says.


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