Pharmacy Benefit Manager

Every state in the nation has proposed bills to limit pharmaceutical drug prices and the pace of that legislative work increases each year. The usual responses from pharmaceutical manufacturers and their allies is to threaten to reduce their investments in new drug research and development and challenge the new state laws in federal court. In […]

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  • Publications

    Navigating Legal Challenges to State Efforts to Control Drug Prices: Pharmacy Benefit Manager Regulation, Anti-Price-Gouging Laws, and Price Transparency

    States have passed an unprecedented number of laws addressing drug prices over the past few years and some have faced legal challenges. This NASHP legal brief explores those challenges and highlights how states can develop effective drug pricing policies to avoid legal challenges. The brief analyzes the arguments industry groups have made against pharmacy benefit manager regulations, […]

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  • New Recipes to Control Rx Pricing

    Thursday, August 22, 10 am – 11:30 am This session offers new policy ideas for controlling drug prices. The proposals will be based on deliberations by NASHP’s Pharmacy Cost Work Group, the group who developed the “Call to Action” on drug prices in 2016. Since then, other policies have emerged, including new strategies for regulating […]

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  • State Health Policy Blog

    Montana Explores a New Approach to Regulating Pharmacy Benefit Managers

    State legislatures across the country continue efforts to address the opaque business practices of pharmacy benefit managers (PBMs) to protect consumers and lower prescription drug prices. Montana is taking a new approach by leveraging its insurance department’s regulatory authority over insurance carriers by proposing a bill that tasks insurers with responsibility for overseeing that PBMs […]

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  • State Health Policy Blog
    States Take Administrative Actions to Curb Medicaid Drug Costs

    States Take Administrative Actions to Curb Medicaid Drug Costs

    During the 2018 legislative session, 28 states passed 45 laws to curb the rising cost of prescription drugs. In addition to legislative solutions, states are taking administrative action to better manage state spending on Medicaid pharmacy benefits. Ohio, West Virginia, and Vermont offer examples of states taking innovative administrative approaches to rein in drug costs. […]

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  • Comparison of State Pharmacy Benefit Managers Laws

    Comparison of State Pharmacy Benefit Managers Laws

    In 2018, 21 states passed 32 bills to shed light on the opaque business practices of pharmacy benefit managers (PBMs). States took varied approaches to curb prescription drug costs by regulating PBMs. The chart below details the PBM practices each state tackled, and how their approaches compare with NASHP’s PBM model legislation.   Footnotes 1. Bills […]

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    October 4, 2018 | Filed under: Front Page-Rx, Importation, Pharmacy Benefit Manager, Rx

  • State Health Policy Blog
    New NASHP Model Legislation Helps States Bring Transparency to Pharmacy Benefit Managers

    New NASHP Model Legislation Helps States Bring Transparency to Pharmacy Benefit Managers

    The National Academy for State Health Policy (NASHP) has released model legislation to help states shed light on the opaque business practices of pharmacy benefit managers (PBMs). States can use the model bill to require the licensing of PBMs, ban gag clauses that prevent pharmacists from sharing lower-price drug options with consumers, and require more […]

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  • Pharmacy Benefit Manager Model Legislation: Questions and Answers

    Pharmacy Benefit Manager Model Legislation: Questions and Answers

    These questions and answers explain the role pharmacy benefit managers (PBM) play in the drug supply chain and highlight NASHP’s model PBM legislation that states can use to better oversee PBMs and protect consumers. What are pharmacy benefit managers? Pharmacy benefit managers (PBMs) contract with health plans to administer their pharmacy benefits. Depending what a health […]

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  • State Health Policy Blog
    Twenty-Eight States Passed 45 Bills to Curb Rising Rx Drug Costs in the Short 2018 Legislative Session

    Twenty-Eight States Passed 45 Bills to Curb Rising Rx Drug Costs in the Short 2018 Legislative Session

    *Updated Oct. 15, 2018 Despite a short legislative season, state lawmakers across the country introduced an unprecedented 174 bills to stem the rising cost of prescription drugs and have enacted 45 into law — with seven state legislatures still in session. Last year, state legislatures introduced 100 Rx cost control bills and passed 27. Register […]

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  • A Glossary of All Terms Pharma

    A Glossary of All Terms Pharma

    If you’re working to control the cost of prescription drugs, you need to know the lingo used by the pharmaceutical industry. Below is a glossary of terms commonly used by players in the drug research, regulation, manufacturing, distribution, and purchasing worlds. Drug Product Terms Brand product: Branded products are not generic drugs or products. A brand can be […]

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