ATAP Sends a Letter to Senator Skoufis Expressing Support of S1768

ATAP is supporting a bill proposal by Senator James Skoufis, a member of the New York State Legislature, to bring about transparency in PBM contracts and help ensure affordable access to medications for our patients. We may be calling on our ATAP membership and others to help with this initiative. Please see the letter below.

March 31, 2021

Honorable James Skoufis

188 State Street, Legislative Office Building, Room 815

Albany, NY 12247

Re: Support of NY S1768 – Pharmacy Benefit Managers Reporting/Transparency

Dear Senator Skoufis:

On behalf of the Alliance for Transparent and Affordable Prescriptions (ATAP), a group of twenty-eight (28) patient and provider groups, I am writing to express our support for S 1768. This bill seeks to ensure that new patients do not pay inflated costs for their prescriptions. S 1768 increases transparency and accountability for Pharmacy Benefit Managers (PBMs). As you may be aware, PBMs are third-party entities that are hired by insurers and health plan sponsors to manage and administer prescription drug benefit plans.

ATAP is concerned about the role PBMs play regarding the alarming price increases in the total cost and out-of-pocket costs of prescription drugs for patients, resulting in the loss of patient access to affordable and life-saving medications. Using their intermediary position, Pharmacy Benefit Managers (PBMs):

· Negotiate rebates and discounts with pharmaceutical manufactures in exchange for including the manufacturer’s drug on the PBMs tiered formulary.

· Determine which patient medication the PBM will cover and how much the patient will pay for their medication per the tiered formularies.

· Negotiate rebates and discounts for medications, meant to drive down the cost of medications for patients, which are pocketed by the PBMs within opaque contracts.

· Prohibit pharmacists from informing patients that the copayment amount for their medications may be higher than paying the retail (“cash”) price for their medication.

NY S1768 will help remedy many of these practices by:

· Eliminating “spread pricing,”

· Identifying all sources of PBM income, including any pricing discounts, rebates, claw backs and fees,

· Oversight of PBMs by the NY Department of Financial Services (Department) including making the payment model for administrative fees available to DFS,

· Allowing for the amending of PBM contracts subject to Department approval,

· Providing for a pass-through pricing model for pharmacy benefit manager, and services

· Establishing a maximum administrative fee if warranted by the Department

In closing, I want to reiterate ATAP’s support of S 1768. These reforms are vitally important to efforts to contain drug prices and discourage abuses by PBMs. ATAP is happy to be a resource as you consider SB 1768. If you have any questions about our position, or if you would simply like to learn more about how PBMs operate in the marketplace, please contact Joseph Cantrell at jcantrell@rheumatology.org.

Sincerely,

Robert W. Levin, MD President, ATAP