South Central Reporter

South Central Reporter

Thursday, November 21, 2019

ILLINOIS STATE SENATE DISTRICT 48: Manar proposal to crack down on out-of-control PBMs signed into law


By Press release submission | Sep 4, 2019

Illinois State Senate District 48 issued the following announcement on Aug. 26.

A measure sponsored by State Senator Andy Manar (D-Bunker Hill) that would provide relief for independent, rural pharmacies was signed into law by Gov. JB Pritzker Friday.

Pharmacy benefit managers, or PBMs, which negotiate drug prices on behalf of insurers, are currently using their position to drive up prices and eliminate competition, putting local pharmacies at a disadvantage.

House Bill 465 includes several provisions that will impose Illinois’ first ever oversight on PBMs, including:

=Eliminating the gag clause that prevents pharmacists from suggesting lower cost prescriptions to patients;

=Preventing consumers entering the emergency room from being denied coverage; and

=Improving pricing transparency and saving state money by requiring the Department of Healthcare and Family Services to approve contracts that impact the state’s Medicaid program.

“It’s vital for consumers, taxpayers and pharmacies to curtail the PBM abuse which is costing Illinois hundreds of millions of dollars annually,” said Owen Sullivan, who operates Sullivan Drugs in Carlinville. “We’re lucky to have a champion like Sen. Manar who will stand up for the businesses and constituents of Illinois against this corporate greed.”

In some rural communities, artificially high drug prices have caused local pharmacies to close, forcing consumers to travel miles to purchase needed medications.

“PBMs are creating unprofitable environments that make it difficult to sustain business for independent pharmacies, and the result is that we’re seeing these businesses closing all the time in Central Illinois,” said Michelle Dyer, who operates Michelle’s Pharmacy in Carlinville, Gillespie and Bunker Hill. “This is a great step to reign in the abusive powers that PBMs use against independent pharmacies.”

PBMs are largely unregulated and have not been subject to oversight, auditing or transparency laws in Illinois, even though they manage public money through the Medicaid program.

“PBMs line their pockets at the expense of small businesses and consumers who have no choice but to buy lifesaving drugs at exorbitant prices,” Manar said. “For years these middle men have been able to exert their influence on the pharmaceutical industry with essentially no oversight. It’s time to crack down on unfair practices that target some of the most vulnerable people in our communities.”

House Bill 465 will go into effect January 1, 2020.

Original source can be found here.

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