HARRISBURG — As third-party administrators of drug benefit programs for health plans, pharmacy benefits managers have seen success in containing costs. But concerns are surfacing because the terms of these agreements are often unknown to consumers, and some practices have been questioned for their effectiveness. A bill sponsored by Sen. Lisa Baker (R-20) is aimed at alleviating several of the most prominent problems identified.
“Our interest is in limiting as much as possible what Pennsylvanians have to pay for prescription drugs,” said Baker. “We need to be more aggressive in policing this process so our citizens are not unknowingly paying more than they should for medicines they need.”
The legislation is the result of a public hearing Baker conducted last year into concerns about anti-consumer aspects of the system of pharmacy benefit managers.
“There are certain practices, such as spread pricing and gag clauses, which may result in bigger profits for companies and higher costs for customers. We find there are available remedies to correct the situation. We can draw on what neighboring states – Ohio and Maryland – have successfully done to save money for their consumers,” Baker explained.
In addition to banning spread pricing and gag clauses, Baker is also seeking to require the use of federal guidelines to set the price of prescription drugs filled through Medicaid and to establish a program rewarding pharmacies and pharmacy benefits managers if some compliance and cost saving measures are met.
“This proposal contains the principles of transparency and fairness that we are trying to apply in every area of state law,” Baker stated.
“This is not to diminish the importance of the savings realized since the pharmacy benefit manager system has been in place. Rather, our experience shows there are changes that can and should be made to provide a better deal for prescription drug purchasers,” she added.
To read my co-sponsorship memo, click here.
Andrew M. Seder