Whitmer Signs Bills To Regulate Pharmacy Benefit Managers
February 23, 2022
By Jessica Mathews / email@example.com / Associated Press
Governor Gretchen Whitmer has signed bi-partisan bills designed to reduce prescription drug costs by regulating pharmacy benefit managers that oversee coverage for employers, insurers and others.
Whitmer said today that the changes will improve transparency and "help lower inflated prices.” Three pharmacy benefits managers, or PBMs, dominate the U.S. market: CVS Caremark, Express Scripts and OptumRx. They have come under growing scrutiny for their role in drug costs. They say big drug companies are to blame.
In 2018, then-President Donald Trump signed bills to stop insurers and PBMs from barring pharmacists from telling consumers when paying cash would be cheaper than using insurance.
CVS Health, whose Caremark business is one of the country’s largest PBMs, had asked the Democratic governor to veto the legislation, calling parts that directly affect patients “simply bad policy.” It urged legislators to instead focus “on addressing the true source of higher costs: the high list prices set by big drug companies.”
The three bills in the package have various provisions. House Bill 4348 will lower the costs of prescription drugs and make medication more affordable, including insulin. Another allows pharmacists to provide the current selling price of a drug the pharmacy dispenses or comparative current selling prices of generic and brand name drugs it dispenses without being asked.
arts of the laws take effect immediately while others, including licensure requirements and bans on “spread pricing” and “gag clauses,” begin in 2024.
Provisions going into effect immediately include prohibitions on requiring patients to pay a co-pay that is higher than the selling cost of the drug; and discriminating against certain hospitals and other entities that provide discounted medication to Medicaid patients.
Whitmer commented “For too long, unlicensed pharmacy benefit managers have been able to engage in practices that drive up costs for Michiganders whose lives and health depend on critical prescription drugs like insulin. This bill brings much-needed transparency to our healthcare system and is a testament to what we can do when we put Michiganders first. I am grateful for the work of my Prescription Drug Task Force for their recommendations and our legislative partners who joined with us to get this done.”
Whitmer's press release is attached.