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Measure to Save Patients Money at the Pharmacy Builds Momentum

posted: May 29, 2018

The Ohio Association of Rheumatology (OAR) and nearly 30 other organizations have joined the Ohio Prescription Partnership coalition to push for Pharmacy Benefit Managers (PBM) reform legislation.

The coalition is supporting House Bill 479 (Prescription Drug Co-Pay Integrity Act), which will prohibit the practice of PBMs requiring pharmacists to charge patients an amount greater than the pharmacy’s cash price for a particular prescription drug. Second, the legislation would prohibit "gag clauses" that some PBMs place in pharmacy contracts that penalize pharmacists for disclosing a complete picture of the financials of a patient’s prescription drug transaction.

Most recently, the Ohio Department of Insurance (ODI) has effectively prohibited PBMs and/or health insurers from engaging in each of the following practices: 

  • Prohibiting any person, directly or indirectly, from informing, by any means, an individual about less expensive ways to purchase prescription drugs that may also be available under any insurance policy or benefit plan.
  • Requiring cost-sharing in an amount, or directing a pharmacy to collect cost-sharing in an amount, greater than the amount an individual would pay for the prescription drug if the drug were purchased without coverage under a health benefit plan.

House Bill 479 was voted out of the House Government Accountability and Oversight Committee and now heads to the House Floor for a full chamber vote. The OAR government affairs team will continue to monitor this legislation and will provide updates as needed.

Read the Bill