Pharmacy benefit managers — businesses that act as middlemen between drug manufacturers and pharmacies — wouldn’t be able to bar pharmacists from telling consumers about lower-cost drugs if a new bill passes.
Introduced in the Assembly Committee on Commerce and Labor on Monday, AB141 would allow pharmacists to advise patients about drugs that could be used as a cheaper alternative to their doctor’s prescriptions.
The pharmacists would not be allowed to dispense the alternative drug. Instead, patients would have to ask their physicians or other prescribing clinicians for a change in the prescription.
“We know that drug costs affect anyone, even the uninsured,” Assemblywoman Melissa Hardy, R-Henderson, told committee members in her presentation Monday.
Her co-sponsor, Republican Assemblyman Glen Leavitt, said after the meeting that industry leaders have indicated pharmacy benefits managers, known as PBMs, currently include so-called “gag clauses” that restrict some Nevada pharmacies from sharing information with patients on lower-cost drugs.
Pharmacy benefits managers play a middleman role getting drugs from manufacturers to pharmacies, often negotiating a discounted rate or receiving a rebate from the manufacturer. They charge their clients based on the original list price that does not reflect the savings they negotiated.
That can force manufacturers to drive up prices in anticipation of the negotiated discounts, increasing costs to consumers.
No one commented in opposition to Hardy’s bill. But legislators, including Assemblywoman Maggie Carlton, D-Las Vegas, questioned whether it could unintentionally provide pharmacy benefits managers that own pharmacies — CVS Health, for example — with greater kickbacks.
“Some of the articles have talked about the exorbitant profit margins PBMs are making,” Carlton said. “The last thing I would want to do is incentivize” that practice.
Others, including Nevada State Medical Association Executive Director Catherine O’Mara, said they disagreed with language that would allow pharmacists to advise patients of a “more-effective drug.”
“Ultimately, we believe the prescription authority should be left with the … prescriber,” O’Mara told legislators.
Hardy, who presented alongside Leavitt, assured concerned legislators and industry members the language was intended to provide consumers with lower-cost options.
“It’s just to have the information that there possibly is a less expensive alternative,” she said.