*PBM Transparency Senate Bill 670 & House Bill ___

*Talking Point Sheet for Pharmacists, Pharmacy Technicians and Student Pharmacists ONLY (Not for Distribution)

Senate Bill (SB): 670 Bill Sponsor (Senate): Senator Rich Alloway (R-Franklin)

Senate Co-Sponsors: Thank them for their support! Sen. Rich Alloway Sen. Pat Stefano Sen. Bob Mensch Sen. Randy Vulakovich

When discussing this bill, keep in mind the following:

1- Thank current co-sponsors of SB 670. If your Senator is not a co-sponsor, as him or her to co- sponsor and support.

2 - SB 670 will likely be referred to the Senate Consumer Protection and Professional Licensure Committee. If your Senator is a member of the committee, request his or her support and ask that he or she ask Sen. (R-Bucks) to bring the bill up for a vote in the near future.

3- If your Senator is not a member of the committee, ask for his or her support when SB 670 comes before the full Senate for a vote.

Senate Consumer Protection and Professional Licensure Committee members:

Majority Minority Sen. Robert Tomlinson – Chair Sen. - Chair Sen. – Vice Chair Sen. Larry Farnese Sen. Lisa Baker Sen. Art Haywood Sen. Sen. John Wozniak Sen. Stewart Greenleaf Sen. Sen. Dominic Pileggi Sen. John Rafferty Sen. Pat Vance

House Bill (HB): Not Available at This Time Bill Sponsor (House): To be determined

House Co-Sponsors: Unavailable at this time

When discussing this bill, keep in mind the following:

1- PPA is working with House Health Committee staff on identifying a prime sponsor for this bill.

2- Ask your Representative to co-sponsor this bill once a prime sponsor is identified and a co-sponsor memo is circulated.

3- This bill will most likely be referred to the House Health Committee. If your Representative is a member of the committee, request his or her support and ask that he or she ask Rep. Matt Baker (R- Tioga) to bring this bill up for a vote in the near future.

4- If your Representative is not a member of the committee, ask for his or her support when this bill comes before the full House of Representatives for a vote.

House Health Committee members:

Majority Minority Rep. Matt Baker – Chair Rep. Florindo Fabrizio - Chair Rep. Becky Corbin Rep. Kevin Boyle Rep. Jim Cox Rep. Vanessa Brown Rep. Rep. Rep. Rep. Rep. Rep. Pam DeLissio Rep. Kristin Hill Rep. Rob Matzie Rep. Rep. Rep. Tim Krieger Rep. Mike O’Brien Rep. John Lawrence Rep. Mike Schlossberg Rep. Harry Lewis Rep. Ronald Waters Rep. Rep. Marcy Toepel Rep. Rep. Rep.

Important Points:  PBMs provide a useful service in managing prescription drug benefits; however, sometimes their activities go beyond their original purpose and include some questionable practices.

 Transparency helps the insurance market work better. It allows plan sponsors (payers including insurance, companies and government) to ensure that PBMs are providing a service it was hired to do: to lower drug costs.  Often times these entities may not fully understand all of the specifics of contract terms and may be paying more because of this. An example of lack of transparency is when PBMs create a “spread” between the prices charged to the payer and the price reimbursed to the pharmacy which is never disclosed to the payer.  PBMs would be required, upon request, to provide claims-related financial and utilization information including the national drug code numbers used as submitted by the pharmacy for payment, the price paid to a pharmacy, and the price charged to the payer for the same. They also would be required to disclose rebates received from a pharmaceutical manufacturer, upon request.  This bill would establish prohibited PBM conduct. For example PBMs would not be allowed to mandate a patient use a specific pharmacy if the PBM has an ownership interest in the pharmacy and exclude any qualified pharmacy from participation in a particular network.  Confidentiality of a patient’s healthcare information is important. This legislation would establish requirements PBM must follow such as allowing patients to opt out of the sale of their data.  Multiple state governments and plans have saved millions dollars from transparent PBMs.