Manar Unveils Measures to Rein in Drug Monopolies

WBGZ Radio / Alton Daily News

Illinois lawmakers are making an attempt to block drug companies from unnecessarily raising drug costs for patients.
Earlier in the week, State Senator Andy Manar (D-Bunker) unveiled a sweeping package of legislation aimed at establishing a system of checks on the pricing power of pharmacy benefit managers and ultimately lowering the cost of prescription medications.

According to an analysis by CBS News, during the first half of 2019, there were price increases for over 3,400 prescription drugs. Of those, the average price hike was nearly 10.5%, which currently sits at 5 times the standard rate of inflation.
Manar says “ The current system is a result of drug monopolies and PBMs having unrestrained power to set and manipulate prices.”

For a full list of all items included in Manar’s legislation, visit this story at AltonDailyNews.com.
​
Manar’s package of legislation includes:

• SB 3740 - Prohibits spread-pricing, which is when PBMs pocket a portion of the amount paid to them by the health insurer for a prescription drug instead of passing the full amounts on to pharmacies who are dispensing the drug.
• SB 3117 - Gives a PBM a legal obligation to manage health plans for a third party in a way that reflects the best interest of the third party and its beneficiaries. SB 3117 also allows the Department of Insurance to impose fines and revoke a PBM’s license for violating that duty.
• SB 3734 - Prohibits a PBM from reimbursing a pharmacist or pharmacy for a drug in an amount less than the PBM reimburses itself or an affiliate for the same drug.
• SB 3060 - Requires pharmacies to post a notice informing consumers that they may request current pharmacy retail prices at the point of sale. Also requires pharmacies to provide customers directly with the retail price (before insurance) of a prescription drug, in writing and electronically prior to purchase.
• SB 3741 - Prohibits a PBM from requiring a prescription to be filled by a mail order pharmacy as a condition for reimbursing the cost of the drug.
• SB 3543 - Requires all Medicaid managed care organizations to reimburse pharmacy provider dispensing fees and acquisition costs at no less than the amounts established under the fee-for-service program.

CVS Health issued a statement late Monday (March 16) in response to the story:
CVS Health has a proven track record of lowering drug costs and helping improve health outcomes in Illinois.
At a time when drug manufacturers are increasing list prices at a record rate, the several bills introduced by Senator Andy Manar will increase drug costs across Illinois by limiting the ability of PBMs to negotiate and deliver savings for patients, health plan sponsors and taxpayers. By making prescriptions more expensive, drug manufacturers benefit—not patients.
PBMs are estimated to save over $21 billion in Illinois in the next 10 years through their work to negotiate lower prices from drug manufacturers and reducing costs for patients across the state.
In Medicaid, carving out pharmacy benefits would significantly impact the health of the hundreds of thousands of Illinoisans who rely on Medicaid for the prescription drugs they need, and would jeopardize the $2.1 billion in savings that PBMs will generate for Illinois Medicaid over the next decade.
Going forward, we look forward to working with lawmakers to promote high-value, effective care in Illinois by preserving the tools that PBMs use to deliver lower costs for patients.