We're not sure if it's the federal attention being paid to the proposed Medco-Express Scripts merger, state budget pressure, or the advocacy of pharmacists -- probably all three -- but states are taking a second look at PBM laws and there is more attention being paid to these middlemen than we've see in years. For instance, here's an editorial in the Houston Chronicle opposing the merger.
Pharmacists in Alaska turned out to support HB 259, complaining of abusive PBM audit practices. Utah legislation, HB 76, also focuses on these audit practices. The Mississippi Board
of Pharmacy is now implementing its PBM law passed last year.
House Bill 4122 is pending in Oregon, and PBMs have gone on the warpath with a big advertising buy and heavy lobbying. HB 4122 would require PBMs be regulated by the Oregon Board of Pharmacy, and force them to provide insurers and the Oregon Health Plan with information about the rebates and contracts the PBMs enter into with drug manufacturers. The transparency is intended to ensure that PBMs are passing on the savings they generate onto insurers and, eventually, health care consumers. The bill has bipartisan support, and is backed by the Oregon State Pharmacists Association, the Oregon Society of Health-System Pharmacists, and the National Association of Chain Drug Stores.
Bipartisan PBM legislation is also pending in Washington state - HB 2303 and SB 6096. These bills are quite comprehensive and have much in common with the Maine PBM law enacted in 2003 but recently repealed by the new Republican majority there. Unlike in Maine, though, PBM legislation has bipartisan support in most of the country, with Republicans and Democrats alike sponsoring the legislation.
Vermont is also considering PBM legislation, HB 674, posted here: http://www.leg.state.vt.us/docs/2012/Bills/Intro/H-674.pdf
