Changes to Drug Formularies Mid-Year
S.2849, vetoed on December 23rd, would have created a list of safeguards designed to protect patients with private, commercial health insurance plans seeking to remove drugs from their pharmacy benefit formularies, in the middle of a contract year. New York’s current law puts thousands of patients at risk of losing access to therapies for such chronic and life-threatening diseases as epilepsy, rheumatoid arthritis, multiple sclerosis, among many others. It also usurps decisions by physicians as to what the most effective therapy is to treat a patient’s condition. NYSSOS was in support of the passage of the bill.
The Governor vetoed the bill because of concerns that “Insurers would have to anticipate and set rates for hypothetical future drug price increases, causing higher premiums for everyone, while pharmaceutical companies would be able to raise their prices with impunity”.
Pharmacy Benefit Managers
On December 26, the Governor vetoed, S.6531, which would have increased the oversight, transparency and accountability of Pharmacy Benefit Managers (PBMS). According to a recent article published by MSSNY, the Governor vetoed the bill because of concerns that provisions could be pre-empted by ERISA, and invite scrutiny from the FTC and DOJ and “sweep in plans that are not true PBMs, but rather health benefit funds only.”
