“The time has come for Texas to take reasonable measures on behalf of pharmacists and their patients in the name of fair competition and public health."
AUSTIN, Texas (PRWEB) January 13, 2021
State Representative Eddie Lucio, III (D-Brownsville) today filed House Bill 1093, legislation that would increase oversight of pharmacy benefit managers and improve patient choice for prescription drugs. The legislation is one of the Texas Pharmacy Association’s top priorities for the 87th Legislative Session.
Pharmacy benefit managers, or PBMs, serve as middlemen between health plans, patients, and pharmacies, determining not only which prescription drugs are covered but also at which pharmacies patients can fill their prescriptions. The three largest PBMs are responsible for nearly 85% of the nation’s drug claims.
“The time has come for Texas to take reasonable measures on behalf of pharmacists and their patients in the name of fair competition and public health,” Lucio said. “As we continue to fight the COVID-19 pandemic, it is important to increase patients’ access to the pharmacy of their choice to improve health care for all. It’s also essential to pass legislation that supports our state’s pharmacies, many of which are locally owned small businesses.”
PBMs face mounting scrutiny nationwide for their lack of transparency and their role in driving up the cost of prescription drugs. The U.S. Supreme Court, in a unanimous 8–0 opinion issued in December 2020, affirmed that states may act to protect local businesses and their patients from PBM overreach.
“The coronavirus pandemic has highlighted the importance of community pharmacies, which have remained open on the front lines to serve their communities by filling prescriptions, counseling patients, offering COVID-19 tests, and administering COVID-19 vaccines to thousands of patients,” said TPA President Michelle Beall, Pharm.D. “It is critical that we do not allow patients and pharmacies to be harmed by the anti-competitive business practices of these middlemen.”
Increasingly, PBMs engage in self-dealing by directing or requiring patients to use PBM-owned mail-order or specialty pharmacies, limiting patient choice and in some cases, increasing prescription costs. House Bill 1093 prohibits PBMs from steering patients to their own pharmacies, improving market competition and allowing patients to choose the pharmacy of their choice. It also prohibits PBMs from forcing patients to receive medications by mail who would prefer to use a local pharmacy. At the same time, it would allow patients who prefer to receive their medications by mail or delivery to do so from their local pharmacy.
House Bill 1093 also protects small businesses by preventing unfair pharmacy direct and indirect remuneration clawbacks that arbitrarily recoup additional money from pharmacies after the sale. This provision will provide pharmacies with greater business certainty, particularly during the pandemic.