The Source Blog
Recent Action in Pharmaceuticals
Introduced: 2024 Status:
Pharmacy benefit managers and health carriers required to include lower-cost drugs in their formularies, and formulary structure and formulary tiering for each health plan required to give preference to drug with lowest out-of-pocket cost to …
SB521 – Kansas
Introduced: 2024 Status:
AN ACT concerning insurance; relating to pharmacy benefit managers; imposing restrictions concerning the federal 340B drug pricing program; enacting the defense of affordable prescriptions act to prohibit certain discriminatory actions related to reimbursement of entities …
HB24-1438 – Colorado
Introduced: 2024 Status: Enacted
Concerning the implementation of certain affordable prescription drug programs, and, in connection therewith, making an appropriation.
HB 238 – Alabama
Introduced: 2024 Status:
This bill aims to further regulate the practice of pharmacy benefits managers (PBMs) in Alabama. PBMs are intermediaries between insurers and pharmacies that manage prescription drug benefits on behalf of health insurance providers. The bill …
SB 241 – Connecticut
Introduced: 2024 Status:
To require entities authorized to participate in the federal 340B Drug Pricing Program to report to the Health Systems Planning Unit of the Office of Health Strategy certain information regarding the program, including (1) aggregated …
SF 333 – Iowa
Introduced: 2024 Status: In Process
This bill aims to regulate pharmacy benefits managers (PBMs), pharmacies, and prescription drug benefits. It requires that any payments a covered person makes for a prescription drug must be applicable to any deductibles in the …
SF 554 – Iowa
Introduced: 2024 Status: In Process
This bill is designed to regulate the operations of Pharmacy Benefits Managers (PBMs) in the state of Iowa. It introduces a system of reverse auctions to determine which PBM will provide services for public sector …
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District Court: District of Columbia Status: Pending
A complaint filed by Merck, a multinational pharmaceutical company, alleges that the drug price negotiation process detailed in the Inflation Reduction Act (IRA) violates the …
FTC v. Amgen Inc. & Horizon Therapeutics Plc. – Federal
District Court: Northern District of Illinois, Eastern Division Status: Pending
The FTC filed a lawsuit requesting a temporary restraining order and preliminary injunction to block Amgen Inc. from acquiring Horizon Therapeutics. Amgen agreed to purchase …
PhRMA v. Stolfi – Oregon
District Court: District Court of Oregon Status: Decided
PhRMA is challenging Oregon’s drug price transparency laws HB 4005, 2018 (Disclosure Law) and HB 2658, 2019 (Advance Notification Law) alleging that the laws are …
Pharmaceutical Care Management Association (PCMA) v. Mulready – Oklahoma
District Court: District Court of Western District of Oklahoma Status: Decided
The 2019 Oklahoma law, Patient’s Right to Pharmacy Choice Act, targets PBM conflict of interest by prohibiting higher reimbursement rates for PBM-owned pharmacies and bans …
State of Ohio v. OptumRx – Ohio
District Court: Ohio Court of Common Pleas (Franklin County) Status: Pending
On March 15, 2019, Ohio’s attorney general Dave Yost sued OptumRx in Ohio state court, claiming that between 2015 and 2018, the PBM failed to pass …
Pharm. Care Mgmt. Ass’n v. Gerhart – Iowa
District Court: Southern District of Iowa Status: Decided
Trade association representing pharmacy benefits managers (PBM) brought action against State of Iowa, seeking declaration that statute that regulated how PBMs established generic drug pricing …
Pharm. Care Mgmt. Ass’n v. Tufte – North Dakota
District Court: District of North Dakota Status: Pending
Trade association representing pharmacy benefit managers (PBMs) brought action against North Dakota state officials in their official capacities, alleging that Employee Retirement Income Security Act …
Next | See all Litigation Records
News & Opinions
Articles & Reports
Health Affairs August 13, 2024
Health Affairs August 5, 2024
JAMA Internal Medicine December 4, 2023
Trends in Pharmaceuticals
State Pharmaceutical Legislation
Click on highlighted states to see all legislative action to regulate pharmaceutical price and competition in the 2019 session. Click to see 2018 trends for a side-by-side comparison.
2019 Drug Pricing Transparency Legislation
Pharmaceutical price transparency legislation requires disclosures from drug manufacturers and insurers to help lawmakers and the public better understand how drugs are priced and how those prices affect insurance premiums. Click to see 2018 trends for a side-by-side comparison.
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Key:
- Enacted
- Considered
2019 Pharmaceutical Rate-Setting Legislation
Rate setting legislation either establishes the price of a prescription drug or sets the maximum amount a payer can pay for a drug. Click on highlighted states to see rate-setting legislation considered or enacted in the 2019 session. Click to see 2018 trends for a side-by-side comparison.
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Key:
- Enacted
- Considered
2019 Drug Importation Legislation
Click on highlighted states to see drug importation legislation considered or enacted in the 2019 session. Click to see 2018 trends for a side-by-side comparison.
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Key:
- Enacted
- Considered
2019 Drug Price Gouging Prohibition Legislation
Price gouging prohibitions typically empower the state Attorney General to act if the price of a drug is raised above a threshold. Click on highlighted states to see legislation considered in the 2019 session. Click to see 2018 trends for a side-by-side comparison.
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Key:
- Enacted
- Considered
2019 Pharmacy Benefit Manager Regulation Legislation
Legislation to regulate Pharmacy Benefit Managers (PBMs) typically include provisions that 1) require PBMs to register with the state, 2) mandate disclosures by PBMs, or 3) prevent PBMs from incentivizing the use of mail-order pharmacies. Click to see 2018 trends for a side-by-side comparison.
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Key:
- Enacted
- Considered