Montana lawmakers addressing high prescription costs

April 3, 2019 GMT

HELENA, Mont. (AP) — Montana lawmakers are working on several bills to help rein in the high cost of prescription drugs, mostly with a focus on pharmacy benefit managers — the middlemen who negotiate prices with drug manufacturers.

Democratic Gov. Steve Bullock has signed one bill, and several others are moving through the Legislature with strong support.

“I’m pleased that we can all actually agree that pharmacy costs are too high and there are times the pharmacy benefit managers aren’t doing right by Montanans,” Bullock said Wednesday.

He said he hopes lawmakers get him the bills early enough for him to determine how they might best work together. “I’ll put ‘em all right next to each other and say ‘What’s the best overall regulatory system that we have,’ ” Bullock said.


The bill Bullock has already signed would prevent pharmacy benefit managers from charging pharmacies unexpected fees, called clawbacks, and would allow pharmacists to inform patients if they could buy a drug at a lower cost than their insurance copayment. The federal government has already prohibited the so-called “gag clauses” that prohibit offering information about lower prices.

A bill that passed the House 97-2 on Wednesday also would allow pharmacies to discuss lower-priced options with customers. It goes back to the Senate to consider an amendment.

A bill requested by the state Auditor’s Office, which has passed the Senate and was endorsed 82-18 in the House Wednesday, would give insurance companies that sell policies through the marketplace the regulatory backing to negotiate better contracts with pharmacy benefit managers. It faces a final House vote Thursday.

State Auditor and Insurance Commissioner Matt Rosendale has argued pharmacy benefit managers are pocketing too much money and choose the types of drugs they’ll cover based on the rebate they receive from manufacturers.

The bill, which requires rebates to be returned to the insurers and used to reduce premiums, has been adopted by the National Academy of State Health Policy as model legislation for addressing prescription drug prices. Maine has introduced a similar bill. Rosendale said his office has been in contact with lawmakers in Louisiana, Texas, North Dakota and Rhode Island about the legislation.

The state employee health plan has used similar contract requirements to save millions of dollars, the auditor’s office said.

Lobbyists for drug companies supported the bill, but companies that offer insurance policies on the exchange said they can already negotiate such contracts with pharmacy benefit managers.

Another bill would require pharmaceutical manufacturers to justify the cost of their drugs if the price increases by more than 10 percent a year or if the drug costs more than $100 per month or for a single course of treatment. It has passed the House and has a hearing in a Senate committee next week.