manar 031120SPRINGFIELD – Following the launch of a statewide drug affordability campaign, State Senator Andy Manar (D-Bunker) today unveiled a sweeping package of legislation aimed at putting checks on the pricing power of pharmacy benefit managers (PBMs) and lowering the cost of prescription drugs for Illinoisans.

According to an analysis by CBS News, in the first half of 2019 alone, prices increased for over 3,400 prescription drugs. The average price hike is 10.5%, or 5 times the rate of inflation.

“Data shows the pharmaceutical industry has sky-high profit margins while the cost of vital medications continues to climb at four and five times the rate of inflation. The numbers illustrate a legalized price-gouging racket fortified by political influence,” Manar said. “The current system is the result of drug monopolies and PBMs having unrestrained power to set and manipulate prices, and the failure of lawmakers to stand up for the rest of us.”

Manar’s package of legislation includes:

  • SB 3740 - Prohibits spread-pricing, which is when PBMs pocket a portion of the amount paid to them by the health insurer for a prescription drug instead of passing the full amounts on to pharmacies who are dispensing the drug.
  • SB 3117 - Gives a PBM a legal obligation to manage health plans for a third party in a way that reflects the best interest of the third party and its beneficiaries. SB 3117 also allows the Department of Insurance to impose fines and revoke a PBM’s license for violating that duty.
  • SB 3734 - Prohibits a PBM from reimbursing a pharmacist or pharmacy for a drug in an amount less than the PBM reimburses itself or an affiliate for the same drug.
  • SB 3060 - Requires pharmacies to post a notice informing consumers that they may request current pharmacy retail prices at the point of sale. Also requires pharmacies to provide customers directly with the retail price (before insurance) of a prescription drug, in writing and electronically prior to purchase.
  • SB 3741 - Prohibits a PBM from requiring a prescription to be filled by a mail order pharmacy as a condition for reimbursing the cost of the drug.
  • SB 3543 - Requires all Medicaid managed care organizations to reimburse pharmacy provider dispensing fees and acquisition costs at no less than the amounts established under the fee-for-service program.