Category Archives: Transparency

Virginia Enacts Drug Price Transparency Law

On March 24, 2021, Virginia Governor Ralph Northam signed HB 2007, adding Virginia to the growing list of states that have enacted drug pricing transparency measures. The new law, which takes effect January 1, 2022, establishes drug price transparency requirements for manufacturers, wholesale distributors, PBMs, and carriers.

The legislation establishes an annual (by April 1) reporting requirement for manufacturers with respect to 1) brand-name drugs and non-biosimilar biologicals with a WAC of $100 or more for a 30-day supply or course of treatment and any increase of 15% or more in WAC over the preceding calendar year;… More

Active Summer in State Drug Pricing Transparency Laws

During the summer of 2019, a number of states enacted new drug price transparency laws, swelling the number of states with such laws to 11.  Colorado, Maine, Maryland, Texas, and Washington joined California, Connecticut, Louisiana, Nevada, and Oregon with transparency laws.  Oregon also supplemented its transparency laws with an advance notice requirement for certain price increases.

Washington: On May 9, Washington enacted HB 1224. … More

Massachusetts Senate Ways and Means Budget Maintains Drug Price Rebate Language

On May 7, 2019, the Ways and Means Committee of the Massachusetts Senate reported its final budget (S.4), which includes within it authority for the Commonwealth’s Executive Office of Health and Human Services (“HHS”) to directly negotiate supplemental rebates with drug manufacturers for covered drugs on behalf of the Massachusetts Medicaid program, MassHealth.  The operative language appears in outside sections 4 and 39 of the budget and is substantially similar to drug rebate language initially appearing in the Governor’s FY20 budget.… More

Maryland Forges Ahead on Drug Price Transparency

Only weeks after the Supreme Court declined to hear Maryland’s appeal of the 4th Circuit decision striking down the state’s recent drug price transparency law, the Maryland legislature has again resolved to address prescription drug pricing.  Recently cross-filed Senate and House bills in the new legislative session incorporate many of the same reporting requirements underpinning the now invalidated 2017 law, but expand the scope of the reporting requirements to include PBMs and insurance carriers in addition to prescription drug manufacturers.… More

Massachusetts Senate Passes Bill Aiming to Increase Drug Price Transparency and Notification Obligations

On October 17, 2017, the Massachusetts Senate Working Group on Health Care Cost and Containment and Reform (initially convened in the fall of 2016) released draft legislation entitled “An Act furthering Health Empowerment and Affordability by Leveraging Transformative Health Care.”  The Massachusetts Senate engrossed the bill, with significant amendments, on November 11, 2017 (the “bill”).  In addition to proposed changes in the regulation of hospitals and insurers operating within the state,… More

PhRMA Mounts Legal Challenge to SB 17 in California

The recently enacted California drug price transparency law SB 17 is facing a legal challenge to its constitutionality in the form of a PhRMA lawsuit filed in the US District Court for the Eastern District of California on December 8.  In PhRMA v. Brown, PhRMA is seeking declaratory judgment that the drug pricing provisions of SB 17 are unconstitutional and a permanent injunction against their implementation and enforcement.… More

California OSHPD Announces SB 17 Implementation Plan

California’s Office of Statewide Health Planning and Development (OSHPD) has released an implementation plan for California’s new drug transparency law SB 17.  The first part of the law to take effect will require manufacturers of drugs experiencing greater than 16% increases in WAC over three calendar years to provide 60 days’ advance notice to state purchasers as well as healthcare service plans, health insurers, and PBMs that register with OSHPD. … More

California SB 17 Enacted

On October 9, California Governor Jerry Brown signed SB 17, legislation mandating advance notice and price transparency reporting for drugs experiencing greater than 16% increases in WAC over three calendar years and new drugs introduced at a WAC above the Medicare Part D specialty drug threshold.  The legislation will take effect January 1, 2018, although the reporting requirements to the Office of Statewide Health Planning and Development will begin in the first quarter of 2019.… 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

Trade Organizations Challenge Nevada’s Drug Price Transparency Law

We recently wrote about the newly enacted Nevada drug price transparency law here.  The law requires manufacturers of prescription diabetes drugs to disclose certain drug cost information to the state Department of Health and Human Services (“Department”).  In addition, the law imposes several unique reporting requirements on non-profit patient advocacy groups and pharmaceutical sales representatives.  We expected that these reporting requirements would garner some attention and,… 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

Hearings on Massachusetts Transparency Bills Set for July 11

Three pieces of Massachusetts pharmaceutical pricing legislation are set for a hearing before the legislature’s Joint Committee on Healthcare Financing at 11:00 AM on July 11.  S. 652, sponsored by Sen. Mark Montigny, would impose strict reporting requirements on manufacturers of covered drugs, while empowering the state Health Policy Commission (HPC) to annually identify drugs with prices “excessively higher than justified,” and authorizing the Attorney General to bring consumer protection actions against manufacturers charging such prices. … More

Nevada Enacts Drug Price Transparency Law

Nevada Governor Brian Sandoval recently signed into law a drug price transparency bill, SB 539.  The law primarily concerns price transparency measures for prescription diabetes drugs, but also imposes reporting requirements on nonprofit patient advocacy groups and pharmaceutical sales representatives that we’ve yet to see enacted in any other state.

First, the law requires nonprofit patient advocacy groups to annually compile a report disclosing any payment,… More

Federal Drug Price Transparency Legislation Introduced in U.S. Senate

On June 13, Sen. Ron Wyden (D-OR) introduced price transparency legislation that has similarities to the many state bills that have been introduced on the issue in recent years.  S. 1348, entitled the Stopping the Pharmaceutical Industry from Keeping Drugs Expensive (SPIKE) Act of 2017, would impose price reporting requirements on drugs that, per dose 1) have a WAC of at least $10 and have experienced a 100% 12-month WAC increase;… More

Compromise Price Transparency Measures Enacted in Louisiana

Two drug price transparency measures were signed Wednesday by Louisiana Governor John Bel Edwards after passing both houses of the legislature unanimously.  HB 436 passed the Senate on June 2 after having passed the House May 24.  This bill would require manufacturers engaging in marketing of prescription drugs in Louisiana to report quarterly to the Louisiana Board of Pharmacy the current WAC prices for those drugs.

Under SB 59,… 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

Maryland Price-Gouging Legislation to Become Law Without Governor’s Signature

HB 631, Maryland’s first-in-the-nation “price gouging” bill, will become law without the signature of Governor Larry Hogan (R).  In a letter to Maryland Speaker of the House Michael Busch (D), Hogan stated that he would not sign the legislation due to concerns that it could violate the “dormant” application of the Commerce Clause of the U.S. Constitution.  However, Hogan declined to veto the legislation,… More

Massachusetts Senator Introduces Drug Transparency Bill Vesting CHIA and Attorney General with Oversight Authority

On January 19, 2017, Senator Mark C. Montigny introduced S.652 – “An Act to promote transparency and cost control of pharmaceutical drug prices.”  The bill currently sits in the Senate Committee on Health Care Financing, and covers the following categories of drugs: 1) the 10 costliest drugs to private payers in a given year; 2) the 10 drugs causing the highest annual increase in private payer spending;… 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

Maryland ‘Price-Gouging’ Legislation Goes to Governor

In a lopsided 137 to 2 vote on April 10, 2017, the Maryland House of Delegates passed HB 631, which outlaws “price gouging” by manufacturers and wholesale distributors of certain “essential off-patent or generic drugs.”  Price gouging is defined as “an unconscionable increase in the price of a prescription drug.”

The legislation applies to drugs for which exclusive marketing rights have expired,… More

Supplemental Rebates for Medicaid Drugs Enacted with New York Budget

On Thursday, April 20, the Governor Andrew Cuomo signed into law New York’s 2017-18 budget.  The budget adds a new section 280 to the New York Public Health Law which requires the Commissioner of Health to set an aggregate Medicaid drug spending growth threshold for 2017 and 2018, and allows the Commissioner to refer drugs to the Drug Utilization Review Board for pricing reviews when the state is projected to exceed the threshold. … More