Amendment ID: S2202-44

Amendment 44

Prioritizing Prescription Drug Analysis

Mr. Moore moves to amend the bill in section 24, by striking said section in its entirety, and replacing it with the following new section:-

“SECTION 24. Section 1 of chapter 12C of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after the definition of “Patient-centered medical home” the following 2 definitions:

“Pharmaceutical manufacturing company”, an entity engaged in the production, preparation, propagation, compounding, conversion or processing of prescription drugs, directly or indirectly by extraction from substances of natural origin, or independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis; or an entity engaged in the packaging, repackaging, labeling, relabeling or distribution of prescription drugs; provided, however, that “Pharmaceutical manufacturing company” shall not include a wholesale drug distributor licensed under section 36B of chapter 112 or a retail pharmacy registered under section 39 of said chapter 112.

“Pharmacy benefit manager”, a person or entity that administers: (i) a prescription drug, prescription device or pharmacist services or (ii) a prescription drug and device and pharmacist services portion of a health benefit plan on behalf of a plan sponsor including, but not limited to, self-insured employers, insurance companies and labor unions; provided, however, that “Pharmacy benefit manager” shall include a health benefit plan that does not contract with a pharmacy benefit manager and administers its own: (a) prescription drug, prescription device or pharmacist services; or (b) prescription drug and device and pharmacist services portion, unless specifically exempted by the center.” and;

in section 30, by striking said section in its entirety and replacing it with the following new section:-

“SECTION 30: Said chapter 12C is hereby further amended by inserting after section 10 the following section:-

Section 10A. (a) The center shall promulgate regulations necessary to ensure the uniform analysis of information regarding pharmaceutical manufacturing companies and pharmacy benefit managers and that enable the center to analyze: (i) year-over-year wholesale acquisition cost changes; (ii) year-over-year trends in net expenditures; (iii) net expenditures in Massachusetts on a subset of brand and generic pharmaceuticals identified by the center for which the state spends significant health care dollars; (iv) information regarding trends of estimated aggregate drug rebates and other price reductions paid by a pharmaceutical manufacturing company in connection with utilization of all pharmaceutical drug products offered by the pharmaceutical manufacturing company; (v) information regarding trends of estimated aggregate drug rebates and other price reductions paid by a pharmacy benefit manager in connection with utilization of all drugs offered through the pharmacy benefit manager; (vi) information regarding pharmacy benefit manager practices in passing drug rebates or other price reductions received by the pharmacy benefit manager to a private or public health care payer or the consumer; (vii) information regarding discount or free product vouchers that a retail pharmacy provides to a consumer in connection with a pharmacy service, item or prescription transfer offer or to any discount, rebate, product voucher or other reduction in an individual's out-of-pocket expenses, including co-payments and deductibles under section 3 of chapter 175H; and (viii) any other information deemed necessary by the center.

(b) The center shall require the submission of available data and other information from pharmaceutical manufacturing companies and pharmacy benefit managers including, but not limited to: (i) changes in wholesale acquisition costs for up to 10 brand or generic prescription drug products, as identified by the center, on an annual basis, that account for a significant share of state health care spending; (ii) for the manufacturers of the up to 10 drugs identified under subsection (i), aggregate, company-level research and development and other capital expenditures for the most recent year for which final audited data is available (iii) a description, suitable for public release, of factors that contributed to reported changes in wholesale acquisition costs for the up to 10 prescription drug products identified by the center under subsection (i).

(c) Except as specifically provided otherwise by the center or under this chapter, data collected by the center pursuant to this section from pharmaceutical manufacturing companies and pharmacy benefit managers shall not be a public record under clause Twenty-sixth of section 7 of chapter 4 or under chapter 66.

Section 10B:  Notwithstanding the provisions in sections 8, 9, 10, and 10A of this Chapter, to the extent that those sections of this chapter do not specifically enumerate a category of data or other information that an entity must submit to the center, the legislature must prescribe the submission of such data by amending the relevant section.