A Patient Quality, Pricing and Disclosure Act is intended to address the high and rising pricing of prescription drugs.
“The cost of prescription drugs remains a major challenge to people on Cape Cod, on the beaches and throughout Massachusetts,” said State Senator Julian Cyr (D-Truro) from Cape and Beaches.
Cyr said the bill would reduce prices, improve access to drugs, and improve accountability and pharmaceutical industry regulation.
“We are introducing many of the same accountability and monitoring mechanisms that we are effectively enforcing to rein down healthcare costs elsewhere in government,” he added.
“We extend that now in the drug industry.”
The law orders the Health Policy Commission (HPC) to set up a process to define medical cost limits that present a threat to public health in cooperation with stakeholders.
Cyr said some massive unreasonable price hikes are taking place, including insulin.
In about 10 percent of residents who live with diabetes, insulin is a lives-sustaining drug.
Consumers have recently experienced a massive spike in insulin rates, resulting in out-of-pocket costs that somebody on an elevated-deductible plan can reach $1,000 annually or is uninsured.
“Insulin’s value has risen astronomically,” Cyr said. “This is not a new drug, but a life-saving treatment
The PACT Act permits the Insurance Division to license and regulate PBMs and impose penalties on people who do not meet certain criteria.
Pharmacists are not allowed by current law to report to patients when a lower price for prescription medication is accessible.
This can sometimes cause users to pay more than they do now they paid the retail price of the pharmacy for a prescription using their insurance plan.
The PACT Act addresses this by demanding pharmacists to notify patients if a drug’s retail cost is less than its cost-sharing amounts, such as the amount of co-payment, deductible, or other amount needed by an insurance policy.
The PACT Act also allows pharmaceutical companies to alert the government of the launch of new drugs and substantial price changes on existing drugs in advance.
Senators say that with advanced notification, the state’s MassHealth program can start preparing for possible cost rises by discovering ways to mitigate costs or bargaining better prices.
This legislation further empowers the Center for Health Information and Analysis (CHIA) to gather from prescription companies and PBMs a variety of medication cost information and include its results as part of its annual health cost report.