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Drug price transparency could return as top legislative issue

Insurance News Net -

Drug prices and who controls them could be back before the General Assembly this winter, as consumer advocates and pharmacy benefit managers remain at odds over issues such as drug price transparency.

Gov. Brian Kemp signed legislation last year tightening rules on third-party companies that play a role in negotiating pharmaceutical drug prices between insurers and local pharmacies in Georgia.

The bill Kemp signed into law requires companies called pharmacy benefits managers (PBMs) to set drug prices within a national average, a move aimed at reining in excessively high prescription prices.

PBMs act as go-betweens for prescribers and insurance companies that contract with health insurers to negotiate lower drug prices for patients. But critics have long accused them of muddying the process, prompting increases in drug prices and delays in filling prescriptions.

Now, pharmacies such as CVS are worried Georgia lawmakers, when they reconvene in January, may take further action on drug pricing.

"We are aware of efforts by some legislators to further explore drug pricing transparency," said Leanne Gassaway, vice president of state government affairs at CVS Health. "Given the state's enactment of PBM-related legislation nearly every year over the past decade, we would welcome the legislature to closely examine drug manufacturers' role in drug pricing, including a notable lack of transparency in setting and increasing list prices."

Ryan Hamilton, an associate professor at Emory Goizueta Business School, said price transparency typically causes drug prices to fall.

"The easier it is for customers to acquire price information, the greater the need for manufacturers to compete," he said. "But the prescription pharmaceutical industry in the U.S. is so heavily regulated, those general rules may not apply."


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