In Review: The subject matter hearing in Chicago went as expected, with pharmacists, the National Community Pharmacists Association (NCPA), patient groups, the biosimilars association, the Department of Insurance, and even the WV Department of Insurance there to berate PBMs. We had a powerful showing with the CEO of the Illinois Chamber, the Executive Director of the Mason Contractors Association, and a representative from the National Association of Health Underwriters. The hearing was over two hours long, with only three legislators there in person, including Representative Thaddeus Jones (D), the sponsor of HB 4548.
The pharmacists provided their usual rhetoric, and the Department maintained they needed additional regulatory authority denying that they had any authority beyond licensure and doing market conducts reviews. The patient groups blamed PBMs for access issues, and the biosimilar organization followed suit. Prime Therapeutics joined me at the table and provided much-appreciated additional information. The CEO of the Chamber attempted to bring the employer’s voice to the discussion, but Rep. Jones abandoned the goals of consumer protection and transparency and stated clearly that he meant for his bill to protect the pharmacists.
Closing statements were nearly done when Jim O’Connor from the Mason Contractors went back to the table and made a wonderful speech about how PBMs help lower the costs so that his union can continue to offer coverage to the members of the masonry union and their retirees. Then for his closing drop-the-mic moment, he told the members of the committee that the question no one asked during the entire hearing was why were the drugs costing $600 or $80,000. He told the committee that this was the real question they should be asking, and then left the table with that closing comment.
Up Next: Leader Natalie Manley (D) is planning another PBM subject matter hearing on Tuesday, May 7, in Springfield. The HFS Medicaid PBM Audit will be publicly reviewed by the Legislative Audit Commission on Tuesday, April 30, at 9:30 A.M. You can watch the hearing at the following link: Legislative Audit Commission (ilga.gov). PCMA is reviewing possible edits for HB 5395 that would maintain prior authorization provisions for prescription drugs that are currently in the law and additional limitation provisions for step therapy. PCMA continues to work with the Illinois Life and Health Insurance Association to provide feedback on the Governor’s bill.
If you have any questions, please contact Melodie Shrader at mshrader@pcmanet.org.
