Levin’s Pharmacy in Oceanside joins statewide rally

Posted

Dozens of pharmacists in white coats lined the sidewalk outside Levin’s Pharmacy on Long Beach Road in Oceanside, several holding signs and chanting, “Hey, hey, ho, ho, PBMs have got to go!”
Their rally cries were part of a statewide protest by pharmacies across New York state at noon on Oct. 23, urging Gov. Andrew Cuomo to sign legislation that would ease the power that pharmacy benefit managers, or PBMs, have over neighborhood pharmacies.
“The importance of this bill cannot be overstated,” Howard Jacobson, the owner of Rockville Centre Pharmacy, said. “It will protect patients, it will help taxpayers, and it will save neighborhood pharmacies.”
PBMs act as middlemen between pharmacies, on one side, and drug manufacturers and insurance companies, on the other. A lack of oversight of PBMs comes at the expense of independent pharmacies throughout the state, which often face financial hardship because of low reimbursement rates from PBMs, which are not legally required to disclose their revenue streams in New York.
As a result, many pharmacies have gone out of business, and those still operating face major obstacles. The bill would regulate the impact that PBMs have on these businesses.

Pharmacies in Nassau and Suffolk counties took part in the rally, as did many in Albany, Buffalo and other upstate areas. There was a rally at City Hall in Manhattan. Dozens of people attended the gathering at Levin’s.
Its owner, Fred Rigel, bought it in 1992, and has made it into a family business, working alongside his son, Brett. The purpose of the rally, Fred said, was to push Cuomo to sign the bill and raise awareness of the struggles that small pharmacies face.
“Private pharmacy is declining,” Rigel said. “We’re losing volume tremendously. We’re losing patients and profits. You add all of that and you’re out of business.”
Rigel said that many of his competitors have slashed hours and staff, while others have gone out of business. He added that Levin’s tries to foster positive relationships with customers, who have the opportunity to meet with a staff nutritionist if they have questions or concerns.
Suzanne Tzerman said she attended the rally because she has been loyal to Levin’s for three years and enjoyed the quality service that the pharmacy offers her, compared with bigger pharmacies.
“I love Levin’s for the personal attention that they give me,” Tzerman said. “They even know my name when I walk in the door. I can’t get that at any other pharmacy. They fixed my prescriptions that were all scrambled up from a major pharmacy. They synchronized them.”
Rigel said that PBMs — which first appeared in the 1980s as middlemen between insurance companies and employers offering health plans to their workers — impair Levin’s’ ability to provide care.
The PBMs have taken on larger roles recently, with three companies — Caremark, OptumRX and Express Scripts — controlling two-thirds of the market, according to a study by Neeraj Sood, vice dean for research at the Leonard D. Schaefer Center for Health Policy and Economics. The companies are largely free from government oversight, and because they can drop pharmacies from insurance networks, PBMs essentially have the power to cut off their customer base.
The bill regulating their operations was passed by the State Legislature in June, and would go into effect 90 days after Cuomo signed it. It would force PBMs to reveal their profits and obtain certain licenses, among other provisions. Jacobson said the bill would provide a “much-needed check on PBM abuses,” which he said was “long overdue.”
Jacobson also noted that the bill would require PBMs to act in patients’ best interests, and prevent them from substituting a medication without approval from the patient’s prescriber. The PBMs would also have to disclose kickbacks and discounts they receive from drug manufacturers, and the bill would prevent them from forcing pharmacists to keep quiet about lower-cost medication options available to patients. He complained that PBMs had “rigged the system in their favor.”
“Neighborhood pharmacies across this entire state are struggling,” Jacobson said. “We are having a very hard time paying our bills, paying our salaries and paying our rents. We are not here to cry the blues. We just want regulation passed so that we can continue doing what we do: provide health care.”
State Assemblywoman Melissa “Missy” Miller, a Republican from Atlantic Beach who attended the Oceanside rally, recounted a time she had difficulty getting medication for her son, Oliver, 19, who has disabilities, including daily seizures, blindness and developmental delays. Miller said that Jacobson found the medicine for her son, but it came at a heavy price, because it was on back order.
“It cost him money to give it to me,” she said, “because he was forced to spend a certain amount. and that’s more than he could accept from me. That’s what PBMs are doing here. They’re dictating what small companies can charge.”
Rigel said he was pleased with the turnout, but noted that he was unhappy with how many of the neighborhood pharmacies have gone dark. “Pharmacies, we’re always the last in line,” he said. “You see it — the little corner drug stores are basically gone. Quite a few of my friendly competitors are no longer here, and it’s very sad. . . . It’s a major problem.”

Zach Gottehrer Cohen contributed to this story.