The Minnesota Senate Thursday 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.
“Anyone who has to refill a prescription has probably felt the frustration and confusion of watching prices increase with no explanation,” said Sen. Roger Chamberlain. “Like any other business, prices tend to climb when you get middle men involved. This bill reforms the role of pharmacy middle men, so patients can save money when they pick up their prescriptions.”
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.