With Marino’s strategic support, independent pharmacies took on three Fortune 25 companies with unlimited resources
How do you build public support for an issue that affects nearly everyone — but is on nearly no one’s radar? That’s the challenge Marino faced when called on to create a campaign that addressed inequities in New York’s prescription drug distribution system resulting from the role played by pharmacy benefit managers (PBMs), who functioned as prescription drug middlemen.
Our task was to eliminate PBMs from the state’s Medicaid system and institute regulations of their work. Those goals support independent pharmacies’ survival, but this alone did not make a sufficiently compelling case for enacting a major healthcare policy change. We knew legislators would be more responsive to the argument that PBMs were having a negative impact on all New Yorkers.
From that insight, FixRx was born and took the lead in the fight that had been launched by the Pharmacists Society of the State of New York.
Change begins with education: in this case, a campaign to call attention to PBMs and their impact on New Yorkers
Most PBMs operated anonymously, so people had to know what they do before they could understand the problems they introduced into the system. We generated media coverage as a prelude to advocating for legislative action.
The campaign required a collaborative process that tapped the client’s experience and expertise as pharmacists and Marino’s command of effective advocacy. Mutual reliance and trust were essential. Our team had to come up to speed quickly on the intricacies of the subject matter. And our clients — independent small business owners who were unaccustomed to working in our sphere — required extensive input and guidance from Marino.
This interdependence, combined with the human needs that the campaign addressed, made this project particularly rewarding for our team.
An initial victory and a roadmap forward
In April 2019, the campaign scored its first success: the elimination of spread pricing from Medicaid managed care. PBMs had been using this controversial tool to taxpayers’ expense, so while the first achievement was somewhat symbolic for independent pharmacists, it was substantive and significant for New Yorkers overall.
The stage was set to achieve our top priority
A law enacted in April 2020 removed PBMs from Medicaid entirely, and New York reverted to a fee-for-service model. With this victory, we secured the client’s top legislative priority.