The state House passed a comprehensive bill on Friday aimed at regulating pharmacy benefit managers and aiding local pharmacists. The bill had almost unanimous support, with only four members voting against it.
Pharmacy benefit managers (PBMs) are middlemen in the pharmaceutical industry. They’re hired by insurance companies to administer the prescription drug side of health plans and, theoretically, save them money. In doing so, they negotiate drug prices with manufacturers — often receiving large kickbacks in exchange for placing their products on the list of an insurance plan’s approved drugs.
They are also responsible for reimbursing pharmacies when patients pick up prescriptions with only a copay, if anything. Many pharmacists have said that they often receive less than what they paid for some of the most expensive drugs on the market.
Pharmacy benefit managers have been blamed by lawmakers, regulators, pharmacists and doctors for raising the cost of drugs and driving independent pharmacies out of business.
“The practices set forth by some PBMs do create more barriers to good health care delivery for patients who truly need it,” said Rep. Valerie Gaydos (R-Allegheny), the bill’s co-sponsor. “Some PBMs are good. Some have also had some nefarious practices which increase the cost of prescription drugs. And that’s what this bill is trying to address.”
