The Columbus Dispatch
Dave Dillahunt has been forced to watch the same bad movie time after time: An Ohioan receives the crushing news that they have cancer, learns about a medication that can help, but then must wait weeks to get it.
Unfortunately, that's true life for many in Ohio because pharmacy benefit managers require patients to receive their medication through the mail — often from specialty pharmacies run by the PBM — as a requirement for insurance to cover the usually expensive drugs. It may arrive within a couple of days, but horror stories abound of cancer victims who have had to wait much longer.
“People aren’t getting treated in time,” says Dillahunt, executive director of the Ohio Hematology Oncology Society.
“In many cases, the more delay you have, the worse the outcome is going to be.”
All that would change under a bill introduced this week in the Ohio General Assembly by a bipartisan duo of House members: Scott Lipps, a Republican from Warren County northeast of Cincinnati, and Thomas West, a Democrat from Canton.
Instead of waiting a month or more for potentially life-saving medication to treat the newly diagnosed cancer, Ohio
..Dillahunt said the Ohio measure is patterned after laws in several states, including Texas and Georgia.
House Bill 336 also would:
• Forbid PBMs and insurers from requiring pharmacies to obtain accreditation from outside entities, which can cost several thousand dollars.
• Bar health insurers from ordering or directing a consumer to use an affiliated pharmacy, or charging consumers more if they use a pharmacy not tied to the insurer.
• Trim the ability of PBMs to assess big charges for even minor errors during audits of pharmacies, and banning compensation of auditors based on the quantity of violations found.
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