Connecticut lawmakers are expected soon to pass a significantly revised version of Gov. Ned Lamont’s (D) health care cost reduction bill stripped of language that would have barred drug manufacturers from limiting use of contract pharmacies and imposing other conditions on 340B drug sales. Also, the bill’s annual reporting requirements for 340B hospitals were pared back and now apply to all Connecticut 340B providers.
Language prohibiting multiple types of pharmacy benefit manager discrimination against 340B entities was modified. Language was added directing the state Department of Social Services to convene a working group on the 340B program and make recommendations by Jan. 31, 2024.
Tomorrow is the last day of the 2023 legislative session. This morning, an amendment to Lamont’s bill, HB 6669, that would replace it in its entirely was filed. Covered entity representatives say lawmakers are expected to approve the amendment and then both chambers are expected to pass the revised measure.
The 340B contract pharmacy language and original 340B PBM nondiscrimination provisions were still in play Monday. Both were included, but then removed, from must-pass state budget legislation.
The contract pharmacy language’s deletion is a major win for drug manufacturers. Days ago, Louisiana lawmakers passed a bill with similar language and sent to the governor, who is expected to sign it into law. Pharmaceutical Research and Manufacturers of America (PhRMA) is expected to challenge it in federal court, just as it challenged Arkansas’s first-of-its-kind 340B contract pharmacy.
Connecticut 340B provider representatives say PhRMA’s promise to sue the state if it followed Arkansas and Louisiana’s lead played a role in the decision to take the 340B contract pharmacy provisions out of Lamont’s bill.
The Connecticut bill’s new 340B provider transparency provisions already are drawing attention nationally as a possible model for federal action. The new language says starting next year, each Connecticut 340B covered entity must annually report to the state Office of Health Strategy:
- the difference between what it estimates it would have paid during the preceding year for covered outpatient drugs outside of 340B and what it paid for those drugs through 340B
- a summary of how it used the “acquisition cost differential … to leverage scarce federal resources to reach more eligible patients and provide more comprehensive services to such patients.”
Lamont’s original language applied to 340B hospitals only, sought far more detail, and would have required reporting on payments by payers, including patients, to hospitals for 340B drugs.
The new language is comparable to what 340B hospitals now voluntarily report under hospital group 340B Health’s 340B Impact Profile initiative and under the American Hospital Association’s 340B Good Stewardship Principles.
Early this year, a Virginia House subcommittee voted 3-2 against a bill that its sponsor said would have effectively required that state’s 340B hospitals to abide by the AHA’s principles.