Legislature should pass a PBM reform bill
During the last Wisconsin legislative session, legislators introduced two bills relating to the regulation of pharmacy benefit manager (PBM) programs: SB 532 and AB 621. Both bills failed to pass. See https://docs.legis.wisconsin.gov/2017/related/proposals/ab621.
According to the Legislative Reference Bureau, the bills would have allowed the Wisconsin Commissioner of Insurance to regulate pharmacy benefit managers. Certain pharmacy benefit managers would have had to be licensed by the Pharmacy Examining Board.
In my opinion, these were a good bills and should be reintroduced and passed in the next session.
A few weeks ago, DeForest-Windsor Area Grassroots heard about PBMs from an employee of an independent pharmacy. He explained to us some of the abuses experienced nationwide under the PBM system. He described the elaborate system that is drug pricing and payment in the U.S.A. and how it is often manipulated by PBM organizations to the detriment of consumers and independently owned and operated pharmacies.
Some questionable practices that PBMs engage in are gag clauses, copay claw back, mandatory mail order, misleading advertising, and arbitrary changes to copay structures and formularies. Our speaker explained how these practices are used by unscrupulous PBM operators to the detriment of public health and market based price control. He used PBM reform in Arkansas as a specific example of what should be done here in Wisconsin by the Wisconsin Legislature.
Wisconsin ranks in the bottom 10 states in PBM regulation. The Wisconsin legislature should pass now a PBM reform bill, in order to help address the rising cost of drugs and healthcare and have a positive impact on public health and economics. The primary issue is the registration of PBMs with the Wisconsin Commissioner of Insurance. That is what last session's SB 532 and AB 621 would have accomplished. For further information, see the National Community Pharmacists Association research, "Patchwork of PBM Regulation Report."
John Scepanski, DeForest