State regulators should drop plans to mandate a $10.18 “dispensing fee” for each prescription filled by a pharmacy, the Empire Center’s Bill Hammond said in comments submitted Monday to the Department of Financial Services.
The proposed fee is part of a package of regulations aimed at pharmacy benefit managers (PBMs), companies that process drug claims on behalf of most health plans.
Among other provisions, the draft rules would require PBMS to pay pharmacies a minimum reimbursement, including a base price for the drug itself (based on one of two benchmarks) plus a “professional dispensing fee” of $10.18.
“Although the floor price would be paid directly by PBMs, these firms could be expected to pass all or most of the added expense to the health plans that employ them – which is to say almost every health plan in the state, including Medicare plans,” said Hammond, the Empire Center’s Senior Fellow for Health Policy.
“Such a minimum-pricing scheme would impose billions of dollars of additional costs on consumers, employers and taxpayers with no commensurate benefit for the state or its health-care system,” Hammond said.