AUSTIN, Texas, Jan. 13, 2021 /PRNewswire-PRWeb/ -- 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.
Media Contact
Debbie Garza, R.Ph., Texas
Pharmacy Association, +1 512-615-9140,
bsparks@texaspharmacy.org
Twitter
SOURCE Texas Pharmacy Association