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Impact of prescription drug legislation in question

By Steve Metzer

The Journal Record

OKLAHOMA CITY – A bill addressing prescription drug costs and the role of pharmacy benefit managers has a good chance of passing, House Majority Floor Leader Rep. Jon Echols said Thursday.

That’s despite Gov. Kevin Stitt’s recent veto of a similar measure and resistance by the State Chamber of Oklahoma.

House Bill 2632, called the Patient’s Right to Pharmacy Choice Act, would change some rules addressing how PBMs operate. PBMs administer prescription drug plans for the health insurance companies that own them. Their roles include contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims.

They’ve drawn mixed reviews. While they’ve been credited for lowering some consumer costs, they’ve been held accountable for raising others and for unfairly excluding local, independent pharmacies.

“We’ve been wrestling with PBMs in this building for quite some time,” said Echols, R-Oklahoma City. “This (bill) won’t shut down PBMs. They’ll still exist, but they’ll have to compete on a level playing field and be more transparent.”

Among other things, the bill would require PBMs to allow pharmacy participation in any pharmacy network provided they accept terms and conditions. It also would prohibit any restriction on an individual’s choice of which in-network prescription drug provider to use, and prohibit contracts between pharmacies and PBMs from containing so-called “gag clauses.”

“Right now there’s a lot of secrecy about how (PBMs) operate,” Echols said.

Last week, Stitt vetoed Senate Bill 841, which sought to regulate health plans in their administration of prescription drug benefits. In his veto message, the governor raised concerns about federal preemption of state laws regulating plans. Echols said he believes the concern has been addressed in HB 2632 because it shifts the focus of new rules to PBMs.

The State Chamber, which opposed SB 841, also has opposed HB 2632.

“No genuine agreement has been reached between all interested parties,” Chamber President Fred Morgan said in a statement. “More worrisome than (that) is the continued inclusion of an ‘any willing provider ’ mandate in HB 2632 that would severely undermine the quality and affordability of prescription drugs for millions of Oklahomans.”

Echols said he strongly disagrees with the notion that opening networks up to additional providers would result in greater costs for Oklahomans.

“I disagree with the premise that it will increase health care costs,” he said.

While opponents of the measure also argue that there hasn’t been enough study to determine how the legislation would affect consumers and small businesses, Echols noted that independent pharmacies in communities across the state and many of their local chambers of commerce have strongly supported HB 2362.

Opponents also point to a fiscal impact study that concluded passage of the bill would raise premium costs for insurance paid by state employees by $5-7 million. Echols said he didn’t agree with that conclusion, pointing out that the fiscal analysis didn’t take into account ways that local pharmacists often find to save their customers money by suggesting generic or other drug options.

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