NY Pharmacists: PBMs Hiked Generics Prices in Medicaid Managed Care Program

A New York pharmacist group claims the misuse of “spread pricing” by the state’s pharmacy benefit managers has led to increased drug prices — especially for generics.

An analysis commissioned by the Pharmacists Society of the State of New York (PSSNY) found that PBMs have been using “spread pricing” — charging the payer one price for a drug, paying a lower price to the pharmacy that supplies the drug and keeping the difference. The practice is seen frequently in Medicaid managed care and has caused generic drug prices to rise, the association claimed.

Spread pricing has previously been targeted by states such as Ohio, which forced PBMs contracted by its Medicaid program to scrap spread pricing models.