COEUR D'ALENE, Idaho — A new Idaho bill will put money back into the pockets of both patients and pharmacies by targeting pharmacy benefit managers also known as "PBM's." PBM's are third party companies, their stated goal is to monitor and help patients with prescription drug benefits.
Idaho Representative Jordan Redman has been behind the new law, bringing lawmakers and local pharmacists together for over a year to make this bill a reality.
But, according to Rep. Redman, these PBM's have found ways to pull money from both patients and pharmacies. He said these costs have caused pharmacies across the state of Idaho to close their doors.
"Most of these pharmacists were losing money trying to dispense a drug or getting an average of ten cents to dispense a drug," said Rep. Redman.
On the patient side of the business, Rep. Redman told KREM2 that rather than taking care of patients, they are finding ways to charge more costs. Rep. Redman said high costs will decrease patients' access to care.
In national headlines, the Federal Trade Commission came out with a report this summer, stating PBM's are manipulating markets. Then, in September the FTC announced they are suing CIGNA's Express Scripts, CVS' Caremark and United Health's Optum Rx due to inflated insulin cost.
Idaho is leading the charge on the state level, to combat this complex national issue.
Rep. Redman said the new law will also give rebates. “The manufacturers will give a rebate for the amount of drugs they produce. Our goal, we have a pass-through mechanism, so that that rebate will directly go back to the patient. Rather than the pocket of the PBM.”
When he brought this bill to session, Rep. Redman said he received push back from PBM's and insurance companies. Lobbyists traveled to Idaho, from Washington to D.C to pressure Governor Brad Little to veto the bill. Although, Gov. Little held strong.
As the new year arrives, Rep. Redman said the goal is to ensure long-term sustainability by encouraging pharmacies to stay open and giving patients affordable access to care.