The New York State Department of Financial Services (DFS) is looking to tighten its grip on the control of Pharmacy Benefit Managers (PBMs). In what DFS describes as “the most comprehensive set of market conduct rules for pharmacy benefit managers in the country,” proposed regulations have been announced that would broaden the state’s oversight scope for PBMs. The full details of the proposed regulations can be found
here.
The expansive regulations, once enacted, would supervise an array of PBM activities. Mirroring the meticulous nature of DFS’s plans, the regulations would go as far as to oversee contracts with network pharmacies and disallow preferential treatment. In essence, the regulations are an effort by the DFS to make the PBM market fairer and more transparent.
In the face of growing concerns relating to conflicts of interests and the economic impact on patients, the discussions surrounding the oversight of PBMs has been a hot topic among legal professionals. States beyond New York are expected to take note of these developments and may take similar steps. The proposed regulations place a magnifying glass over areas of the PBM market that have been largely unregulated at the state level, making this a noteworthy development for the corporations and law firms involved with PBMs.
While the consequences of such sweeping changes are yet to be fully understood, it is evident that the landscape of the PBM market is facing significant changes. Legal professionals within the healthcare sector and beyond would do well to follow these developments closely.