On Tuesday, July 16, 2019, Governor Kate Brown signed Oregon HB 2185, relating to pharmacy benefit managers, into law: https://olis.leg.state.or.us/liz/2019R1/Measures/Overview/HB2185
The bill, supported by the Oregon State Pharmacy Association (OSPA), establishes some basic fair practices:
- Allows patients the option to use a local pharmacy instead of mandating use of a mail order pharmacy;
- Allows local Oregon pharmacies to mail or deliver prescriptions to their patients;
- Ensures a pharmacist can alert a patient that a prescription could be purchased at a lower cost if paid out of pocket, rather than purchased through a PBM benefit plan;
- Defines Specialty Drugs to drugs which cannot be supplied to patients through a retail pharmacy
- Allows Oregon long term care pharmacies the ability to dispense needed urgent drugs to fragile patients in nursing homes;
- Prevents PBMs from reimbursing 340B pharmacy services differently from other identical services in their networks;
- Creates rules and enforcement provisions requiring PBMs to pay pharmacies, at minimum, their acquisition price for a drug; and
- Eliminates retroactive fees, clawed back after payments from PBMs to pharmacies have already been made
In a letter to the Governor, Government Affairs Advocates Bill Cross and Niki Terzieff stated: “The opaque bloating of Pharmacy Benefit Management (PBMs) companies within our health care delivery system has created an oligopoly in the pharmacy market. PBMs dictate rebates to manufacturers and reimbursements to pharmacies; they prevent patients from choosing how, where, and when they fill their prescriptions; [they have] taken center stage as a black box, unable to be examined by regulators or legislators easily.”
OSPA Legislative Chair, Kevin Russell, stated: “A pharmacy cannot stay in business without the customers which come with the major PBMs. Even large bargaining groups have lost their power to bargain with PBMs. A pharmacy either signs non-negotiable contracts or loses their customers. PBMs have abused this power by not only slashing reimbursement rates but also actively trying to disadvantage pharmacies in their network so that patients must go to their PBM-owned pharmacies. In short, PBMs represent an enormous and unregulated conflict of interest in health care. HB 2185 is a regulatory beginning to restore balance and allow local pharmacies to continue to serve patients in their communities.”
The Oregon State Pharmacy Association (OSPA) was founded in 1889 as a professional trade association representing its member community of pharmacists, pharmacy technicians, pharmacy students and others who have an interest in advancing the practice of pharmacy through advocacy and education, and thereby improving the health of our fellow Oregonians.
For more information or to join, please visit www.oregonpharmacy.org.