The Source Blog
Recent Action in Pharmaceuticals
Introduced: 2024 Status: In Process
Amends existing law to establish provisions governing pharmacy benefit managers.
HB 596 – Idaho
Introduced: 2024 Status: Enacted
Amends existing law to establish provisions governing pharmacy benefit managers.
HB 876 – Maryland
Introduced: 2024 Status: In Process
This bill aims to regulate how pharmacy benefits managers (PBMs) operate in regards to specialty drugs. PBMs are companies that manage prescription drug benefits on behalf of health insurers. The bill prohibits PBMs from requiring …
HB 880 – Maryland
Introduced: 2024 Status: In Process
This bill amends the reimbursement levels for drug products that the Maryland Medical Assistance Program (a state-funded health insurance program for low-income residents) is required to establish. This also applies to pharmacy benefit managers that …
HB 340 (Companion Bill SB 388) – Maryland
Introduced: 2024 Status: In Process
Requiring the Governor in fiscal year 2025 and each fiscal year thereafter to include in the annual budget bill an appropriation of at least $1,000,000 for the Prescription Drug Affordability Fund which provides funding for …
SB 388 (Companion Bill HB 340) – Maryland
Introduced: 2024 Status: In Process
Requiring the Governor in fiscal year 2025 and each fiscal year thereafter to include in the annual budget bill an appropriation of at least $1,000,000 for the Prescription Drug Affordability Fund which provides funding for …
SB 526 – Maryland
Introduced: 2024 Status: In Process
Prohibiting certain pharmacy benefits managers from requiring a beneficiary to use a specific pharmacy or entity for a specialty drug if the drug is dispensed by a physician, used in the treatment of a certain …
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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 …
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News & Opinions
Noah TongJuly 16, 2024
Modern Healthcare StaffJuly 15, 2024
Lauren BerrymanJuly 11, 2024
Liz Essley Whyte, Anna Wilde MathewsJuly 10, 2024
Articles & Reports
Health Affairs Forefront November 28, 2023
Health Affairs Forefront November 16, 2023
Health Affairs November 6, 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