Give consumers a choice on prescriptions

An op-ed piece published in the Albany Times-Union on August 2, 2011.  Submitted by Senator George Maziarz and Assemblyman Carl Heastie.

We are a Democratic assemblyman from an urban district in the Bronx, and a Republican senator from a rural and suburban western New York district. What do we agree on? Not much.

But we have something important in common. We have heard repeated concerns from constituents who were blocked from filling prescriptions at neighborhood pharmacies that have served their families for generations. It turns out their insurance providers forced them to buy prescriptions from mail-order companies rather than their trusted pharmacists.

Here's something we can agree on--that's not right. Consumers should have the choice to obtain their medicine from their neighborhood pharmacies. So we have taken action to stand up for them in Albany.

We've come together to sponsor legislation to give customers a choice in filling prescriptions covered by insurance plans, instead of forcing them to use mandatory mail order. Still, no one would be forced to give up mail order if that is their choice. And the neighborhood pharmacist will have to meet insurance plans' parameters on how much prescriptions cost, both to the plan and in co-pays. Our colleagues passed the bill overwhelmingly and we hope to send it soon to Gov. Andrew Cuomo for his signature.

Giving consumers choice sounds reasonable, but our efforts are not without opposition. One of the stranger claims we have seen in our time in the Legislature is the complaint by multi-billion dollar pharmacy benefits managers that allowing local pharmacists to compete fairly with out-of-state mail order prescription houses gives those neighborhood stores a competitive edge. It's as if Goliath complained that David's slingshot gave him an unfair advantage.

Express Scripts, one of the largest of those mail order houses, just moved to buy Medco, a smaller competitor, for $29 billion. Something tells us the mom-and-pop pharmacies that serve our constituents are worth a bit less.

But mail order houses and the PBMs are making just that argument in opposing real competition in the business of filling prescriptions.

But consider the facts. A recent Consumer Reports survey found 90 percent of respondents said independent pharmacists provide far superior service than mail order. Since local pharmacies rely on prescriptions for 93 percent of their revenue, they have to offer excellent service. Generic drugs account for 83 percent of those prescriptions, not higher-cost brand name drugs where PBMs claim their side deals with pharmaceutical manufacturers give them an edge.

Furthermore, increasing numbers of employers, unions, institutions and individuals that buy health insurance are revising their plans to end mandatory mail order. New York's largest municipal union recently amended its health plan to end mandatory mail order after complaints from members. One central New York pharmacist worked for three years to prove to employers that shifting away from mandatory mail order doesn't cost more.

In this environment, consumers deserve a choice. Let's allow consumers to choose to patronize local pharmacies that create jobs in New York. Let's give them transparency so they can comparison shop and make an informed judgment about where to fill their prescriptions.

Competition drives prices down, not up. Let the market decide.