2/24/22 - Gov. Whitmer Signs Bills To Help Bring RX Cost Down

Thursday, February 24, 2022 at 9:24 AM

Governor Whitmer signed bills that are designed to reduce prescription drug costs. Part of the plan includes regulating pharmacy benefit managers.

DELTA TOWNSHIP, Mich. — Pharmacy benefit managers oversee coverage for employers, insurers and others.

Gov. Whitmer said Wednesday that the changes will improve transparency and “help lower inflated prices.

Three pharmacy benefits managers, or PBMs, dominate the U.S. market: CVS Caremark, Express Scripts and OptumRx. They have come under growing scrutiny for their role in drug costs. They say big drug companies are to blame.

House Bills 4348, 4351, and 4352 are based off recommendations by Governor Whitmer’s Prescription Drugs Task Force.

House Bill 4348 Details:

Helps make necessary medications affordable for Michigan families, including insulin
Prohibits pharmacy benefit managers (PBMs) from practicing “spread pricing” in which PBMs drive up costs when reimbursing pharmacists for prescription drugs
Prohibits PBMs from forcing pharmacists to sign “gag clauses” so that pharmacists can communicate openly and honestly with patients about options
Charges Department of Insurance and Financial Services (DIFS) with the responsibility to regulate PBMs licenses
Requires PBMs to file transparency reports with DIFS to ensure Michiganders have access to information about the backend cost and profits of the medications they are prescribed

House Bill 4351 Details:

Prohibits a pharmacy benefit manager (PBM) or carrier from:

Requiring a patient to pay a co-pay that is higher than the selling cost of the drug dispensed to him or her
Excluding or discriminating against a pharmacy solely because the carrier does not have a vested financial interest in the pharmacy
Discriminating against 340B Program entities – the 340 Program is a federal program that provides medication to Medicaid patients at a discount
Makes PBMs and health insurance carriers third party administrators, requiring them to maintain a certificate of authority and follow TPA conduct requirements

House Bill 4352 Details:

Allows pharmacists to provide the current selling price of a drug the pharmacy dispenses or comparative current selling prices of generic and brand name drugs it dispenses without being asked

Prohibits pharmacies or pharmacists from agreeing to a contract that:

Prohibits disclosure of drug prices and comparative selling prices of generic and brand name drugs,
Violates the provisions of HB 4351 relating to 340B entities and carrier prohibitions, or
Prevents or interferes with a patient’s right to receive an eligible drug from a 340B entity.

2/24/22 - Gov. Whitmer Signs Bills To Help Bring RX Cost Down

Share

More from State

Search 91.3 WCSG