This bill introduces the Access to Lifesaving Medicines Act, which aims to regulate prescription drug costs and protect consumers from excessive out-of-pocket expenses. The legislation defines several key terms, including health insurers, pharmacy benefits managers (PBMs), and various cost-related concepts like “excess cost burden” and “rebates”. The bill prohibits health insurers and PBMs from imposing excess cost burdens on insured individuals, which means patients cannot be charged more at the point of sale than the actual net cost of the medication after applying discounts and rebates. When administering pharmacy benefits, PBMs must offer health benefit plans the option to extend point-of-sale rebates directly to enrollees. The bill also establishes that prescription drug cost-sharing must be calculated using the lowest of several potential amounts, such as the standard copayment, maximum allowable cost, or the price without insurance. Additionally, the Insurance Commissioner is directed to create rules to implement these provisions. The act is set to become effective on November 1, 2025, and is designed to increase transparency and reduce prescription drug costs for consumers in Oklahoma.