Indiana House to Vote on Stopping PBMs From Squeezing 340B Entities

An Indiana House committee last week unanimously passed a bill to stop pharmacy benefit managers (PBMs) from discriminating against 340B covered entities.

State Rep. Edward Clere’s (R) bill, HR 1393, is now before the full House. There is no companion bill in the state Senate. The House Financial Institutions and Insurance Committee voted 13-0 to pass HR 1393. Feb. 22 is the last day this session for the full House to vote on bills. The legislature is scheduled to end this session on April 29.

Clere’s bill’s would forbid PBMs from paying less than National Average Drug Acquisition Cost, or wholesale acquisition cost if NADAC is unavailable, for covered entities’ 340B-purchased drugs. The bill also would forbid imposition of discriminatory fees or other discriminatory contract provisions on 340B covered entities, or interfering with a patient’s choice to receive a prescription drug from a 340B covered entity.

“340B is a term you don’t hear a lot , but it makes a big difference to patients who are served because of it,” Clere said during the Feb. 8 committee hearing on his bill. “We’re trying to make sure that [PBM] discriminatory [contract] provisions are prohibited, and refocus the 340B program on the vulnerable patient population it was designed to benefit.”

Chris Roberson, Director for Compliance and Community Programs of the Indiana Hemophilia and Thrombosis Center, said that during the 17 years he has worked with the center, it has tripled the number of patients it serves thanks to 340B program savings. “Over the past five to 10 years, there absolutely has been a trend in PBMs recognizing that we are participating in the 340B program and either reimbursing us less or imposing the type of fees or restrictions covered in this bill.”

Alan Witchey, President and CEO of the Damien Center, Indiana’s oldest and largest AIDS service organization, told the committee, “It’s not an exaggeration to say that thousands of individuals get their medications and medical care specifically because of this program….It does truly allow you to serve the most vulnerable in the community.”

Drew Thomas, Finance and Operation Program Director at the Indiana Primary Care Association, testified that the bill ensures that community health centers and other covered entities maintain access to 340B savings “and reinvest them back into patient care and services that perhaps aren’t reimbursable.”

No payers or PBMs testified at the hearing.

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