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

Massachusetts Governor Again Proposes Excise Tax for “Excessive” Price Increases

On January 27, 2021, Governor Baker of Massachusetts issued his FY 2022 Governor’s Budget. The budget legislation includes an anti-drug price increase measure that has previously been proposed by the Baker Administration on multiple occasions. Under the legislation, drug manufacturers “who establish[] an excessive price [meaning WAC] for any such drug directly or in cooperation with a related party, shall pay a per unit penalty on all units of the drug ultimately dispensed or administered in the commonwealth.”

Whether a drug price is excessive is determined by relation to the drug’s “reference price.” A drug’s “reference price” is the WAC of the drug on the later of January 1,… More

Maine Establishes a Prescription Drug Affordability Board

Following the recent trend in northeast states, Governor Janet Mills recently signed into law An Act To Establish the Maine Prescription Drug Affordability Board, which according to advocates is designed to lower prescription drug costs in the state.  The Board will consist of 5 members, with each member having expertise in either health care economics or clinical medicine.  Two of the members will be appointed by the Senate President,… 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 Enacts Medicaid Supplemental Rebate Law

On July 31, 2019, Governor Charles Baker signed a law designed to increase supplemental rebates for prescription drugs in the Massachusetts Medicaid program (MassHealth).  This law follows on a somewhat similar law enacted in New York in 2017.

Under the new Massachusetts law, the state’s Executive Office of Health and Human Services (EOHHS) can propose and negotiate for supplemental rebates for covered outpatient drugs directly with pharmaceutical manufacturers under an exemption to the Massachusetts public procurement law. … 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

Massachusetts House Pushes Medicaid Supplemental Rebate Law in Budget

On April 11, 2019, the Massachusetts House Committee on Ways and Means released its FY 2020 budget (H.3800).  The legislation includes provisions authorizing MassHealth (the Massachusetts Medicaid program) to negotiate supplemental rebates directly with drug manufacturers, and provides for further proceedings before the Health Policy Commission for manufacturers refusing to negotiate supplemental rebates at levels satisfactory to the Commonwealth. These provisions represent amendments to a MassHealth drug pricing proposal included in Governor Baker’s FY 2020 filing in January.… 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