The Minnesota Senate Wednesday unanimously passed a bill to improve oversight of Pharmacy Benefit Managers (PBMs), the middle men in the supply chain of getting medicines to patients. This bill requires transparency and accountability for PBMs, eliminates gag clauses, and mandates adequate pharmacy networks. It also enables pharmacists to substitute more affordable alternative medications on behalf of patients and allows patients to synchronize their medication fill-dates once a year without cost. Under this new law the common PBM strategy of clawing back dollars from local pharmacies and utilizing rebates for their own self-interest will end.
“Pharmacy benefit managers are middle men who had too much power and control until now,” said Sen. Julie Rosen. “It shouldn’t be that way. When it comes to the medicine you need to live, you deserve the best information and the most affordable prices. We still have a lot more to do, like my comprehensive pharmacy benefit reform bill, but reforming the rules surrounding these pharmacy middle men is one of the easiest ways to lower costs.”
Patient protection reforms contained in the bill include:
- Requires PMBs act in good faith and notify health plans of conflicts of interest.
- Requires new transparency measures of PBMs.
- Mandates PBMs disclose any pharmacy ownership interests they have and prohibits. them from offering incentives or imposing penalties that could direct patients to pharmacies they own.
- Prevents pharmacies from dispensing a drug to the consumer if there is a less expensive equivalent.
- Requires PBMs to disclose out-of-pocket cost differences between preferred network pharmacies and regular, in-network pharmacies.
- Requires pharmacies to inform customers if they can save money by paying cash for their drugs rather than involving insurance.