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PSN on March 25, 2010 - 4:35pm
Both to address the burden of prescription drug costs for consumers and ease their own state budgets, states across the country are moving reforms to lower the cost and increase the quality of prescription drug decisions made by providers.
Regulatory Oversight of Pharmacy Benefit Managers: One key goal is to increase state oversight of Pharmacy Benefit Managers (PBMs). The provisions in this model regulate PBMs by requiring transparency, a fiduciary relationship, and annual audits to insure that the full value of negotiated discounts, rebates, or other financial considerations are passed through. In 2010, legislators in Arizona (HB 2272) and Iowa (SB 20171) have introduced comprehensive PBM oversight (mirroring PSN model legislation), while 11 more states (Alaska, Georgia, Massachusetts, Michigan, Missouri, Nebraska, New Jersey, Oklahoma, South Carolina, West Virginia, Wyoming) have bills moving in their states that contain some PBM provisions.
Expansion of 340B Program: Another key reform establishes commissions to explore ways of expanding the number of provider entities who could qualify under the 340B drug pricing program. As 340B prices are a dramatic 19% to 20% lower than the purchase price of prescription drugs through Medicaid, states stand to realize significant savings by moving segments of their Medicaid population, or others who receive prescription services from the state, to a 340B program. In 2010, Arizona (HB 2272) and Iowa (SB 2071) have introduced expansions of their 340B programs, while North Carolina is exploring the possibility of moving a bill once their session begins in May.
Prescriber Education Services and Drug Industry Gift Bans: In an effort to improve the quality of health care, another key policy is prescriber education services (also referred to as academic detailing) while also requiring drug companies to either disclose gifts to providers or ban them altogether. Comprehensive bills have been introduced in Arizona (HB 2705) and Iowa (SB 48), while companion bills containing some of the prescriber education language is moving in Minnesota (HB 1640 / SB 895). Colorado has a gift ban (SB 126) bill with related provisions.
To view a full map of prescription drug reform bills moving in the states, please click the map above, or click here.
For model legislation, talking points, analysis of recent cases, ideas for messaging, a list of allies, and reports on the subject, please visit our Prescription Drugs Reforms campaign page.