Analysis Shows PBMs Took Big Markups in New York

January 28, 2019

A new study shows that pharmacy benefit managers are putting increasingly large markups on generic drugs in New York. The Pharmacists Society of the State of New York analyzed data from 17 private Medicaid plans and 11 independent pharmacies.

In 2017, PBMs paid independent New York pharmacies an average of $10.85 per generic drug prescription, but private health plans that provide Medicaid coverage reported a cost of $14.34 per prescription—a 32 percent markup. That markup is more than double what it was in 2016, according to the analysis.

“New York’s Medicaid program wastes millions every year by overpaying drugstores,” said Charles Cote, a spokesman for The Pharmaceutical Care Management Association, a trade group representing PBMs. “By defending wasteful spending in a program that’s clearly in trouble, New York’s special interest drugstore lobby wants to rearrange deck chairs on the Titanic without offering ways to keep Medicaid afloat.”

Read the Bloomberg story.