An Act Regulating Rebates By Pharmacy Benefits Managers.
Impact
If enacted, SB01011 will amend Title 38a of the general statutes related to insurance and drug pricing. This regulation enforces that PBMs must not only calculate rebates at the point of sale but also certify their compliance with the Insurance Department. This measure aims to enhance transparency in drug pricing and potentially lower costs for consumers by ensuring that the prices they encounter reflect any financial benefits provided to the PBMs by manufacturers.
Summary
SB01011, introduced by Senator Somers, aims to regulate the practices of pharmacy benefits managers (PBMs) concerning the calculation of rebates at the point of sale for prescription drugs. The bill mandates that an enrollee's defined cost-sharing for each prescription must be calculated based on the net price of that drug. Essentially, this means that consumers will have their out-of-pocket costs determined with consideration of any rebates that PBMs may receive from drug manufacturers, striving for more transparent pricing at the pharmacy counter.
Contention
Discussions surrounding SB01011 might highlight various points of contention, especially regarding the operational capabilities of PBMs and their relationships with pharmaceutical companies. Supporters of the bill argue that it will lead to increased consumer savings and greater regulatory oversight of PBMs, while opponents could raise concerns about the operational burdens placed on PBMs and the potential for reduced access to medications due to altered pricing structures. As the bill progresses, it is likely to generate debate about the balance between cost control and the complexities of the medicative supply chain.