Cuomo says drug prices could come down with tighter regulations
By David Reich-Hale
Gov. Andrew M. Cuomo said he will push for tighter state regulations on pharmacy benefits managers such as CVS Caremark and Express Scripts in a push to control skyrocketing drug prices.
PBMs act as the middle man between health insurers and pharmacies. When a patient fills a prescription, he or she pays a copay. The PBM collects the balance of the payment from the insurer, passes a portion of that on to the pharmacy that dispensed the drug, and pockets the rest. The difference between what the PBM collected and what it passed on is the spread. PBMs — which set both amounts — do not have to disclose to insurers how much they pass on to pharmacies, or disclose to pharmacies how much they collect from insurers.
The governor’s pitch comes less than a month after he vetoed a bill that advocates said would have placed limits on how PBMs operate.