I always enjoy doing a periodic check in on what states are doing when it comes to healthcare issues. Utilizing the excellent data base resources at the National Conference of State Legislatures, one can examine numerous categories of legislation that is being considered before the 50 states and the District of Columbia.
The last check in was in February and provided a general overview of health related legislation, including biosimilars, prescription drug abuse and pricing. But as prescription drug pricing has been one of the issues that has risen to the top when it comes to the national election cycle, that is the specific focus of the day.
When we last checked in six months ago, there were 160 bills related to pharmaceutical pricing in 30 states. Pharmaceutical pricing is a broad category and does not reflect solely bills related to transparency, which is a subset of the category. You should note that the category of pharmaceutical pricing also includes matters of payment and reimbursement.
As of this week, there are now 193 bills introduced before the various state legislatures among 40 states.
How have this year’s crop fared?
As most might guess, introducing legislation is one thing, getting it passed is quite another. Bills fail because they are voted down or the session adjourns and they just expire quietly. Some fail because even though they get passed, they are vetoed. Many await their fate in committee, while others are off on the sidelines waiting for legislatures to take action then the session begins again. Here is a breakdown of the 193 bills that were introduced this year involving pharmaceutical pricing:
The bills that failed comprise nearly half of all bills introduced. Most of those passed added regulation over the activities of pharmacy benefit managers vis a vis maximum allowable cost lists – an area included in the overall topic of pharmaceutical pricing.
Two notable exceptions involved Connecticut which authorized a study of prescription drug pricing by establishing a task force that will study value-based pricing and issue a report and Vermont which provided for pharmaceutical cost transparency related to price increases. At least four other states, Massachusetts and New York, Pennsylvania and Virginia, had transparency in pricing legislation in the Pending category.
Outside of pricing, also check out the NCSL report on State Laws and Legislation Related to Biologic Medications and Substitution of Biosimilars for the most recent profile of how states are responding to the advent of FDA-approved biosimilars.