Op-Ed: Protect The Patient-Pharmacist Relationship

May 21, 2024

By Mikhail Bershadsky, PharmD

When I was in high school, I lost my grandmother to pancreatic cancer. She was my closest friend and my biggest cheerleader. Her passing was a tragic experience that inspired me to pursue my passion for patient-centered care; I began volunteering at a nursing home to honor her memory. After graduation, I dove head-first into the world of health care by working as a pharmacy technician before earning my doctorate in pharmacy at Long Island University.

Now, I work as a Pharmacy Manager at a CVS Health Specialty Retail CarePlus location here in Manhattan – and it’s my dream job. Each day, I get to train young pharmacists and help New Yorkers and their families manage serious diseases.

“I am honored to serve underprivileged communities and patients …”

I am honored to serve underprivileged communities and patients, including individuals whose native language is not English. Communicating with patients in their native tongues is just one way my staff and I personalize their care. Speaking to a patient in Russian allows me to combine care and community in a way that delivers the best possible patient experience.

At our specialty pharmacy, many of the drugs we dispense treat serious conditions like cancer or multiple sclerosis. Due to the complex nature of these diseases, the medications that treat them often come at a high price, causing serious concern for many of my patients at the pharmacy counter.

Thankfully, pharmacy benefit managers (PBMs) go head-to-head with big drug companies to lower the cost of prescription drugs for patients like mine. PBMs like CVS Caremark work hard to secure savings for New Yorkers who would otherwise struggle to afford these life-saving medicines.

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However, I am worried that regulations being considered by the New York State Department of Financial Services (NYDFS) could disrupt this important work by removing the tools that enable PBMs to negotiate lower drug costs on behalf of patients.

The NYDFS initially rolled out these misguided regulations last fall, but they quickly revoked them after outcry from plan sponsors, including major labor unions. Unfortunately, the revised proposal does little to address the real cause of the higher drug costs: the high prices set by drug companies.

I would fully support any initiative to increase the affordability and accessibility of prescription medications; however, these regulations as proposed could have the opposite effect – and drive up costs for the patients I serve, the plan sponsors, including the federal and state government, that help fund their health insurance.

Furthermore, these regulations could pose a threat to patient safety if a plan sponsor’s ability to require that specialty pharmacies meet strict standards is eliminated. Specialty drugs often

require more careful handling and storage protocols than other medications. Patients taking specialty drugs are frequently on multiple medications that, if not carefully reviewed by a specially trained pharmacist, may increase the likelihood of adverse drug interaction.

Specialty pharmacies like mine meet quality and safety standards that exceed those in traditional pharmacy settings, including maintaining specialized storage capabilities and providing additional training for pharmacists on proper medication-handling practices.

Patients fighting cancer or New Yorkers trying to grow their family via fertility treatment need the peace of mind that comes with knowing that their treatments are administered with appropriate and stringent safety protections.

“I take the time to help them understand their treatment plan …”

With each patient I see, I take the time to help them understand their treatment plan and make sure they are familiar with their prescribed medications. Beyond clinical support, I make sure they can take full advantage of the tools available to them to reduce their out-of-pocket costs – the very tools that would be inhibited by the NYDFS’s proposed regulations.

Every so often, I will treat a patient who suffers from pancreatic cancer; I make sure to give them the same quality of care I would have wanted for my own grandmother. As a pharmacist, it is my responsibility to make sure my staff takes this same approach and strives to meet this same standard. When training new pharmacists, I take great pride in helping to shape the next generation of specialty pharmacists who will serve New Yorkers for decades to come.

I call on NYDFS to reconsider their harmful proposal, and instead foster the proper regulatory environment to keep these patient-pharmacist relationships strong. For patients fighting serious illnesses, affordable access to quality care makes all the difference.

Michael Bershadsky

Mikhail Bershadsky, PharmD, is a Specialty Pharmacy Manager for CVS Health in Manhattan.

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