Wisconsin Rheumatology Association.

Advocacy

2018 Current State Legislative Bills

Assembly Bill 621
PBM Legislation In Wisconsin

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“In Wisconsin a new bill was just introduced this past week (11/2017) to allow the state itself to regulate pharmacy benefit managers. Basically, the bill would allow the Wisconsin Insurance Commissioner to both oversee and regulate all pharmacy benefit managers that administrate a healthcare plan for residents of the state. It is interesting to note that bill itself, although written by a Democrat (Representative Debra Kolste), was submitted as a bipartisan bill with support from both political parties. Assembly Bill 621 already has received a hearing by the Wisconsin Assembly Committee on Health and is moving rapidly towards being heard by both the Wisconsin Senate and House.”


Senate Bill 669

“This bill prohibits a health insurance policy, referred to in the statutes as a disability insurance policy, or a governmental self-insured health plan from including in a contract for pharmacy services, or allowing a pharmacy benefit manager or another entity to include in a contract for pharmacy services, a provision that prohibits or penalizes a pharmacist’s disclosure to an individual purchasing a prescribed drug or device of the cost of a prescribed drug or device, a less expensive therapeutically equivalent drug or device, or a less expensive method of purchasing the drug or device. This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.”


Assembly Bill 679 — Biosimilar Substitution

Wisconsin State Assembly’s health committee met on February 01, 2018 on Assembly Bill 679, an act to address biosimilar substitution at the pharmacy level.

The state Senate passed the measure as Senate Bill 575 last week with the governor anticipated to sign in April 2018.

Under the bill, pharmacists can dispense cheaper interchangeable biosimilars instead of brand-name biologics unless the prescriber opposes the substitution. This strategy would follow the current process for the substitution of generic drugs in the pharmacy setting. The bill defines an “interchangeable biological product” as a biological product that the FDA says meets standards for interchangeability pursuant to federal law. Thus far, however, the FDA has not granted any biosimilar an interchangeable designation.

The Wisconsin State Journal reports that the 2 Republican lead sponsors of the bill, Representative Mike Rohrkaste and Senator Leah Vukmir, presenting in the Assembly, say that allowing pharmacy-level substitution could save consumers up to 20%. “This bill will result in the lowering of prescription drug prices for Wisconsin families and seniors,” said Vukimir during a public hearing in December 2017.

While the specifics of state laws vary, most legislation regarding biosimilar substitution includes 5 principles endorsed by Biotechnology Innovation Organization (BIO), a biotech industry trade group. “BIO considers these principles essential to overcome specific challenges with biologics:

  • Substitution should occur only when the product has the FDA’s interchangeable designation
  • Prescribing physicians should be able to prevent substitution
  • If substitution occurs, physicians should be notified
  • The patient should be notified of the substitution
  • The pharmacist and physician should keep records of any substitution”

Assembly Bill 800

This bill prohibits a health insurance policy, referred to in the statutes as a disability insurance policy, or a governmental self-insured health plan from including in a contract for pharmacy services, or allowing a pharmacy benefit manager or another entity to include in a contract for pharmacy services, a provision that prohibits or penalizes a pharmacist’s disclosure to an individual purchasing a prescribed drug or device of the cost of a prescribed drug or device, a less expensive therapeutically equivalent drug or device, or a less expensive method of purchasing the drug or device. This proposal may contain a health insurance mandate requiring a social and financial impact report under s. 601.423, stats.