The bill Kemp signed into law requires companies called pharmacy benefits managers (PBMs) to set drug prices within a national average, a move aimed at reining in excessively high prescription prices.
PBMs act as go-betweens for prescribers and insurance companies that contract with health insurers to negotiate lower drug prices for patients. But critics have long accused them of muddying the process, prompting increases in drug prices and delays in filling prescriptions.
Now, pharmacies such as CVS are worried
"We are aware of efforts by some legislators to further explore drug pricing transparency," said
"The easier it is for customers to acquire price information, the greater the need for manufacturers to compete," he said. "But the prescription pharmaceutical industry in the
Hamilton said PBMs serve as an interface between drug manufacturers and pharmacies.
"Any measures to cut out middlemen from the equation are naturally going to cause protests," he said.
"PBMs support and practice actionable transparency that enables patients, their physicians, and health plan sponsors in
"Discussions over PBMs have been going on for several years, and the legislature seems pretty fired up over continuing that effort," Colbert said, explaining that PBMs were formed to help health insurers negotiate better deals with pharmaceutical manufacturers, and then pass those savings along to consumers.
"But realistically, it's hard to know if those savings are actually being passed along," Colbert said. "Pharmacies and health insurers are buying up PBMs, and it's become especially hard to see where savings are being accumulated."
One bill that will definitely carry over into January is House Bill 164, entitled the Prescription Drug Consumer Financial Protection Act. It would require health insurers to pass along no less than 80% of all prescription drug rebates to their enrollees.
"That 80% is consistent with what the Affordable Care Act requires," Colbert said.
"We've been having some very fruitful discussions and we're anticipating a very active legislative session," said Gassaway, who is tackling a tough public relations challenge: convincing lawmakers and their constituents that making drug prices openly and readily available to the general public will, in fact, lead to higher drug prices.
"If we just put the prices out in the public domain, that information will be used to further manipulate the market," she said. "We are not opposed to showing our clients how much we save them on drugs. We try to push that price down but putting a specific discount out into the public domain will only cause prices to rise.
"We have some other, great ideas on how to make that information available to patients in more useful ways."
Gassaway touts CVS' member-specific benefit information, which includes plan information, deductibles and other data that, the company said, lets health-care providers and CVS members know if a specific drug is covered as well as the member's cost.
PBMs are also now required to submit to new audits by the state