Category Archives: All Payers

Tennessee and Connecticut Become the Latest States to Target Accumulator Adjustment Programs

In just the last few weeks, Tennessee and Connecticut joined the growing list of states to pass legislation banning the use of accumulator adjustment programs. As my colleague Erik explained earlier this month, manufacturers often provide cost sharing assistance programs to help patients afford certain high-cost specialty drugs. Insurers have in turn implemented “accumulator adjustment programs” that seek to reverse the impact of these programs by not counting the amounts provided by the manufacturer in calculating the patient’s annual out-of-pocket limit.… More

Three More States Bar Accumulator Adjustment Programs

Three additional states enacted legislation in recent weeks barring the “accumulator adjustment program” cost sharing framework. Accumulator adjustment programs seek to reverse the impact of manufacturer cost sharing assistance for prescription drugs by not counting amounts offset by such assistance toward a patient’s deductible. This can result in high patient out-of-pocket responsibilities after the manufacturer’s cost sharing assistance has been exhausted. For this reason, both drug manufacturers and patient advocates have sought to bar accumulator adjustment programs on both the federal and state levels.… More

State Drug Price Transparency Legislation: What to Watch for This Fall

After a slow-down during the summer recesses, action on the drug price transparency front is beginning to increase as we enter the fall season.  Here are a few states to watch in the coming months:

California

California’s price transparency legislation, SB 17, passed the legislature on September 13, and now goes to Governor Jerry Brown for his signature.  The legislation had passed the Senate by a 28-10 vote on May 30,… More

California Price Transparency Legislation Passes Legislature

California’s drug price transparency legislation, SB 17, passed the State Assembly on September 11 by a vote of 66-9.  The bill included several amendments to the version of the bill that passed the State Senate at the end of May.  The State Senate then passed the amended legislation on September 13.  Among the most important amendments were changes to “triggers” for price reporting, and for advance notice requirements relative to WAC increases.… More

Transparency Legislation Passes California State Senate

California’s latest effort at a drug price transparency bill, SB 17, moved one step closer to becoming law on Tuesday when it passed the State Senate 26-10.  The legislation, sponsored by Sen. Ed Hernandez, would require the manufacturers of prescription drugs experiencing large increases in WAC to give purchasers 90 days’ advance notice of the increase, and report detailed information to the state Office of Statewide Health Planning and Development (OSHPD). … More

Transparency Legislation Targeting Drug Manufacturers and Health Plans in California Senate Appropriations Committee

One of the more aggressive pieces of price transparency legislation introduced this year is currently before the Appropriations Committee in the California State Senate.  Under SB17, manufacturers of drugs that have experienced three-year increases in WAC greater than either 10% (for drugs with WAC over the Medicare Part D specialty drug threshold) or 25% (for drugs with WAC under the threshold) would be required to give 90 days’ advance notice of the increase to purchasers (including state purchasers,… More

Transparency Legislation Does Not Pass in Washington State Regular Session

The end of the legislative session in Olympia on April 23 did not see the enactment of what had once been among the fastest-moving pieces of drug pricing transparency legislation in the country.  After passing the House of Representatives in a close 52-46 vote, HB 1541 was unable to escape from the Senate Committee on Health Care.

HB 1541 would have required manufacturers of prescription drugs that increase in price by 1) the lesser of 10% or $10,000 over a 12-month period;… More