PINE PLAINS — Highlighting concerns about the immediate and long-term survival of local family-owned pharmacies and an effort to pass legislation which would help control prices those pharmacies pay for drugs, brought U.S. Rep. Pat Ryan, D-Kingston, to the Pine Plains pharmacy on Monday, Feb. 17.
Elected officials, local and area pharmacists and residents attended the event, numbering about 20, said Pine Plains pharmacist Nasir Mahmood during a conversation on Wednesday, Feb. 26. He said he had been pleased at the number of elected representatives who were present.
“We’re trying our best,” Mahmood said. “It’s a matter of getting the legislation into the government funding package and getting it passed,” he added.
The intent of the Feb. 17 event was to underscore the need for reform to the policies which allow pharmacy benefit managers to dictate prices that local pharmacies pay for drugs prescribed for their customers, skimming off the profit margins and leaving local pharmacies to deal with minimal profit or frequently, loss.
Pharamcy benefit managers are the middlemen standing between the pharmaceutical manufacturers and insurance companies, actively negotiating drug prices. Ryan’s office indicated that three major benefit managers control 80% of the current prescription drug market and realize $450 billion in revenue.
Pharmacy benefit managers also systematically reimburse pharmacies less than their cost, which is driving local pharmacies out of business.
Rep. Ryan is attempting to reinstate bipartisan legislation within the Congressional Relief package that will be voted on in mid-March. He is co-sponsor of the Drug Price Transparency in Medicaid Act that would prohibit pharmacy benefit managers from charging Medicaid more than they paid pharmacies for a drug. Another piece of legislation, Pharmacists Fight Back Act, would require adequate reimbursement to pharmacists, prohibiting the benefit managers from steering patients to their own large-chain pharmacies. Major segments of that legislation were included in the December 2024 government funding package, but were removed at the last minute, Ryan’s office said.
Congressman Ryan indicated that March 14 is the deadline for the U.S. House of Representatives to pass the Congressional Relief funding package. He has formally requested U.S. House Speaker Mike Johnson to reinstate the pharmacy benefit reform legislation into that funding bill.
“I am thankful to Congressman Ryan to take this initiative as he has been a friend of independent pharmacies and small businesses,” said Mahmood, who also serves on the board of the Pharmacists Society of the State of New York.
In the 1960s, pharmacy benefit managers began to process drug claims for insurance companies, but by the 1970s they were serving as middlemen between manufacturers, insurance companies and pharmacies, adjudicating prices. Today, they not only adjudicate claims, but now they develop and manage pharmacy networks, determine the list of drugs to be covered by insurance, set copay amounts and serve to channel the patient to a particular choice of pharmacy.
“I’m demanding Speaker Johnson have the courage to stand with the American people and against the Big Pharma companies ripping us all off,” Rep. Ryan said.
