FOR IMMEDIATE RELEASE
October 10, 2019
WINSTON-SALEM, NC (October 10, 2019) -- Pharmacists United for Truth and Transparency (PUTT) is calling on the Wisconsin General Assembly and State Senate to put aside their political differences and turn their collective attention back to patients who need access to medicine from their local pharmacies. SB 100 by Sen. Jon Erpenbach and AB 114 by Rep. Michael Schraa introduce legislation that would put the state’s patients and taxpayers ahead of crass profiteering in state-sponsored healthcare by pharmacy benefit managers (PBMs).
“By now most states have learned that PBM middlemen have invented ways to generate outsized profits for themselves well above what could be considered reasonable and fair to patients and taxpayers,” said Scott Newman, PUTT president. “The fact that Wisconsin legislators had the foresight to begin drafting strong regulation that would keep state taxpayers from paying too much for Medicaid prescriptions is a testament to the commitment Wisconsin lawmakers have to their constituents. But we are greatly disappointed that bills introduced in February are still waiting for a vote because of political infighting. Wisconsin patients and taxpayers deserve better from their leaders.”
SB 100 / AB 114 would disallow the kinds of tactics PBMs have used to develop revenue streams in the hundreds of millions from state Medicaid programs. If passed, SB 100 / AB 114 would:
● Require PBMs to register with the State of Wisconsin in order to do business, ensuring a fair system of regulation and oversight similar to what's currently required of insurance companies already doing business in the state
● Require PBMs to disclose the amount of spread -- the difference between the amount paid to a pharmacy for filling a prescription and what the health plan is charged - to health plan payers
● Prevent PBMs from charging patients a higher copayment than the cash price of the drug and disallow\ the use of contractual “gag clauses”, freeing pharmacists to openly share information with patients about the availability of the lower-cost alternatives to a prescribed medication
PBMs have come under intense scrutiny over the last 12 months as states discover their Medicaid programs have been charged in excess of $200 to $300 million between what pharmacies were reimbursed and what PBMs charged state Medicaid for prescriptions filled. The spread pricing crisis first caught the public’s attention in 2018 when the State of Ohio discovered it had been charged more than $225 million above the cost of Medicaid prescriptions dispensed. A similar study in New York estimated taxpayers had been billed more than $300 million, while studies in Illinois and Michigan revealed similar findings.
“Pharmacies cannot bear the burden of subsidizing their state’s Medicaid plan by being forced to accept below-cost reimbursements for prescriptions,” Dr. Newman said. “No business can sustain while being forced to lose money, and patients depend on their pharmacies for access to medications. As this trend continues we see more and more pharmacies in small and rural communities closing their doors and leaving patients with fewer options to obtain medication. This doesn’t have to happen in Wisconsin. We urge the state legislature to take action immediately and stop PBMs from absconding with millions in tax dollars that could be reinvested back in the state.”
Pharmacists United for Truth and Transparency (PUTT) monitors PBM and other industry practices in the interest of improving the quality, safety and cost of patient care. To learn more about PUTT, visit TruthRx.org .
# # #