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Senate Priority Bill Tackling Prescription Drug Costs Advances

HARTFORD – Thursday evening, Senate Bill 11, which seeks to address prescription drug affordability, passed out of the Human Services Committee. The Senate Priority legislation now heads to the Senate floor.

According to a 2022 study of more than 1,300 Connecticut adults from the Healthcare Value Hub found that:

-Over half (55%) experienced at least one healthcare affordability burden in the past year;

-Nearly 4 in 5 (78%) worry about affording healthcare in the future;

-Over 1 in 4 (28%) of those surveyed with household incomes under $50,000 had rationed medication in the last 12 months due to cost.

-Lower-income respondents and respondents with disabilities are more likely to go without care and incur debt due to excessive and burdensome healthcare costs; and

-Across party lines, respondents express strong support for government-led solutions.

Connecticut Democrats have worked to address various barriers in access to prescription drugs, including capping the out-of-pocket cost of insulin at $25, allowing pharmacists to prescribe birth control, and authorizing the ArrayRx discount drug program, Senate Bill 11 will build upon this work through a number of proposals:

-Establishes a fiduciary duty for Pharmacy Benefit Managers (PBM) to act in the best interest of the health carrier or other health benefit plan sponsor, and requires disclosure of pricing and profits when one parent company owns a PBM, insurer and/or pharmacy

-Prohibits PBMs from charging their plan sponsor more for a prescription than the PBM paid to the dispensing pharmacy, protecting community pharmacies from monopolistic market pressure

-Requires PBMs to use a pricing model that compensates them based on the amount of claims they process rather than the price of drugs sold, thus removing the incentive to drive up prices to increase profit margins

-Requires that drugs purchased by the state are tied to reference prices like those negotiated under the Inflation Reduction Act, allowing Connecticut to leverage federal negotiating power

-Requires certain health benefit plans to make the lowest wholesale acquisition cost insulin available to the beneficiary with no copay

-Establishes a program to import safe, low cost drugs from Canada

-Expands emergency Medicaid coverage consistent with federal law to treat emergency medical conditions, including high risk pregnancies, type 1 diabetes in patients under 21, diabetic emergencies, hypertensive emergencies, labor and delivery and other emergency procedures.

-Requires HUSKY coverage to include GLP-1 prescription drugs (like Ozempic or Weygovy) to treat weight loss, and creates an advisory council to look at lowering the cost of these drugs to the HUSKY program

-Prohibits private insurance from imposing arbitrary time limits on general anesthesia during medically necessary procedures

-Gradually reduces the HUSKY C asset limit until completely eliminated by FY 2030

“Corporate greed is harming consumers in nearly every sector, and the pharmaceutical industry may be one of the greatest offenders,” said Senate President Martin Looney. “The cost of prescription drug prices affects nearly every household in the state and puts extreme pressure on our state budget. This legislation tackles the issue from several angles, from addressing Pharmacy Benefit Managers and determining who exactly they benefit, to exploring cost saving measures like bulk purchasing and a Canadian importation program.”

“People across the country are grappling with prescription drug prices and it can often feel like an issue too large to undertake,” said Senate Majority Leader Bob Duff. “But here in Connecticut, we have a piece of legislation that increases transparency and holds corporate partners accountable, seeks to create international partnerships to import cheaper drugs and creates consumer protections for nursing home residents. Connecticut is just one state affected by this nationwide issue, but instead of waiting in vain for leadership at the federal level, we are taking matters into our own hands to provide relief for Connecticut residents.”

“This bill is a landmark bill to lower prescription drug prices and save taxpayer dollars and the votes on SB11 and the Bipartisan Prescription Drug Task Force mark an important step forward,” said Sen. Matt Lesser, Chair of the Human Services Committee. “I am grateful to the members of the committee for their strong support.”

FOR IMMEDIATE RELEASE
Contact: Garnet McLaughlin | Garnet.McLaughlin@cga.ct.gov