4 State Legislative Actions Affecting Prescriptions

A series of recent bills at the state level are adding to an already busy year for pharmacy-related legislation.

Thus far in 2016, states have enacted or begun considering laws concerning birth control prescriptions, sale of dextromethorphan-containing products, generic drug pricing and payment transparency, and access to medial marijuana.

Here’s a breakdown of a few other recent developments in pharmacy-related state legislation:

1. Louisiana’s Pharmacy Operations Bill

The Pharmacy Operations Bill (SB 131) currently moving through the Louisiana legislature would afford pharmacists more flexibility to let patients know about cheaper drug options.

SB 131 would “allow a pharmacist to be able to sell a prescription drug to one of their customers in certain situations where they may be able to offer them a cheaper price than what their insurance co-pay is,” explained the bill’s author, Senator Ronnie Johns (R-Lake Charles), to Fox 8 Live New Orleans.

Although the bill was filed several months ago, the Senate vote on May 11, 2016, came just days after a report from New Orleans-based investigative reporter Lee Zurich uncovered that patients with health coverage paid more for prescriptions with their co-pays than the drugs actually cost.

Although the current language of the legislation stipulates that it would take effect on August 1, 2016, Sen. Johns believes the implementation date would likely be amended if the bill becomes law.

“We may have to go back and look at some additional language because there are legal contracts that have already been signed by pharmacists with insurance companies, and we may have to deal with the dates in those contracts,” he said.

2. Mississippi’s Network Pharmacist Law

A new state law taking effect on July 1, 2016, will allow network pharmacists in Mississippi to decline to fill a prescription that would pay less than what it costs to purchase those drugs through the contracted pharmacy benefits manager (PBM).

If pharmacists decline to do so, they must provide the patient with information about where the prescription drug in question can be filled.

The law also stipulates that a PBM must pay “the appropriate benefit in full” within 15 days of receiving a claim from a pharmacist or pharmacy.

Many stakeholders, especially independent pharmacists, have touted the law as a victory against the sometimes-murky reimbursement contracts dictated by PBMs.

3. Illinois’ Health Care Right of Conscience Act Amendment

The Illinois House of Representatives recently approved SB 1564, which would amend the state’s Health Care Right of Conscience Act that currently affords health care providers the right to use religious objections to refuse to provide services inconsistent with their beliefs.

As it relates to pharmacists, SB 1564 would prohibit pharmacists from refusing to provide “family planning, counseling, referrals, or any other advice in connection with the use or procurement of contraceptives and sterilization or abortion procedures, [or] medications.”

Health care providers wishing to invoke a right of conscious have 3 options under the bill’s current form:

· Refer the patient to another provider

· Transfer the patient to another provider

· Provide a list of other providers they reasonably believe would provide the service in question

Opponents say the act amounts to requiring pro-life health care providers at all levels to “participate in abortion.”

The bill passed by a 61-54 margin and is now awaiting signature from Governor Bruce Rauner.

4. Arizona’s Substitution of Interchangeable Biologic Medicines Law

Arizona’s new Substitution of Interchangeable Biologic Medicines law allows pharmacists in the state to switch out the medication on a written prescription for a similar medication.

The Biotechnology Innovation Organization said in a statement that the new law “properly preserve[s] patient access to accurate prescription information, maintain[s] incentives for innovation, and promote[s] a competitive market for biologic therapies.”

Therapeutic substitution is a controversial practice because of concerns relating to drug efficacy, adverse effects, drug interactions, and different indications for drugs despite being in the same class.

The law is the first of its kind in the US.