In September 2022, the New York State Department of Health (NYSDOH) made a policy change related to the New York State Medicaid Pharmacy Benefit. This policy change eliminates the ability of Medicaid patients to access oral cancer medications through physician dispensaries, drastically impacting the quality and safety of treatment plans oncologists have established with thousands of New Yorkers.
In response, New York Oncology and Hematology (NYOH) has established the “Save Our Access, Save Our Lives NY” campaign to rally advocates and the concerned public to demand that Governor Hochul and the Department of Health reverse this policy change and restore access.
Before this policy change, Medicaid patients had been able to have their prescriptions conveniently filled on-site at physician dispensaries. This allowed patients to receive the prescriptions at the oncology clinic with the physician, pharmacists and nurses providing one-on-one education on the dosing, side effect management and safe handling of these drugs. Retail pharmacies in the community do not stock oral oncolytic drugs due to the high cost and intricate management required to safely manage patients on these therapies. Without access to physician dispensaries, patients must receive their specialty cancer medications from Pharmacy Benefit Managers (PBM) owned mail order pharmacies. The use of mail order pharmacies results in delays to initiation of treatment protocols and often significant waste as cancer patients often require dose adjustments and changes in therapy after medications have already been mailed to the patient.