State Rep. Ryan Hatfield (D-Evansville) today offered an amendment to House Bill 1042 that puts restrictions on Pharmacy Benefit Managers (PBMs) to lower the costs of prescription drugs for Hoosiers.
This amendment eliminates the ability for PBMs to implement any spread pricing techniques, deny a previously accepted claim, reduce payment to a pharmacy for pharmacist services, or pay a pharmacy or pharmacist less than the national average drug acquisition cost for the prescription drug provided by a pharmacist or pharmacy.
“We have to put a stop to high prescription drug prices in Indiana,†said Hatfield. “PBM’s are the middle men between manufacturers and pharmacies. Without any regulations, they have been left to jack up prescription drug prices at the cost of Hoosier lives.â€
Spread pricing is a technique used by PBMs in which they charge a plan sponsor a contracted price, but that price differs from what they charge a pharmacy or pharmacist. This model encourages PBMs to purchase more expensive prescription drugs, but offer the drugs to pharmacists at a lower reimbursement rate. As a result, PBMs make more money off of these more expensive drugs even though a cheaper alternative is just as effective.
Smaller pharmacies have been negatively impacted by this issue forcing many to close their doors, which is dangerous for rural areas where pharmacies are scarce.
“Ohio recently passed similar legislation that received bipartisan support and was signed into law by a Republican governor,†continued Hatfield. “This is a critical next step toward reducing health care costs in Indiana.
“We must put restrictions on PBMs to ensure that Hoosiers have access to affordable health care. These entities are a huge factor in our skyrocketing prescription drug prices and they must be stopped now before we lose any more Hoosiers because they are unable to afford their life-saving medication.â€
