Government Pricing Updates to State Price Transparency Laws October 4, 2021 John WhitridgeDirector, Operational Consulting 2 Minute Read Patient out-of-pocket costs are rising. With specialty pharmacy prescription revenues growing to $178 billion in 2020 (up 9% from 2019), and 1 in 4 Americans reportedly unable to afford their prescriptions, these are extremely disconcerting trends for life sciences manufacturers as patient initiation and adherence to therapy is essential for achieving successful treatment outcomes. Due to these trends and an overwhelming need for drug price transparency, almost half of all states have signed state price transparency measures into law (with more on the way) over the past few years. These laws place complex new compliance and reporting obligations on pharmaceutical manufacturers, requiring them to report on drug prices and price increases in an attempt to limit drug costs. A few months ago, I wrote about the basics of state price transparency reporting. Because the landscape is constantly changing and evolving, I wanted to give an update on the latest news from individual states regarding price transparency. Minnesota Minnesota is expected to release the final version of its state price transparency bill (SF 1098) prior to the effective date of January 1, 2022, as opposed to the previous date of October 1, 2021. New drafts of the user guide and definitions have been released, but more changes are expected prior to the effective date of the bill. If you’re interested in a deep dive, you can view all regulation text updates here. North Dakota North Dakota has issued guidance that the first reports for the quarterly WAC reports are expected to be submitted via email during the reporting window between October 1 – October 15. While the web portal is still in development, New Drug or Price Increase reports are expected to be emailed to the state at drugtransparency@nd.gov. The state has advised not to include any confidential report information in the body of the email or attachments. Maine Maine has recently passed LD 686, expanding on the Maine Health Data Organizations (MHDO) power to requisition “additional pricing component data” from manufacturers that indicate having launched a new high price drug or taking a qualified price increase. While no new reports have been enacted since LD 686, manufacturers are more likely to get requests for additional information. Oregon Oregon’s annual registration fee has been released on the state web portal by logging on and navigating to ‘Drug Prices’ > ‘Billings’ > ‘Details’ > ‘Print Payment Coupon’ to get all the details. Note that there is an annual baseline fee of $400 plus an additional fee per report that was submitted over the course of the year. Q4 2021 State Price Transparency General Updates The latest version of the Procedure Tracker and Reference deck (v3.4) is preparing to release at the start of Q4 with all the details from above contained as well as updated templates, user guides, and reference material. If you have any questions about navigating these state policies, optimizing your operational readiness, or avoiding compliance risk, reach out to price.transparency@integrichain.com and our team of experts can help guide you through. Learn more about IntegriChain’s State Price Transparency capabilities Sources: 1. 2021 Economic Report on U.S. Pharmacies and Pharmacy Benefit Managers 2. Kaiser Family Foundation Poll About the Author John Whitridge Director, Operational Consulting John Whitridge has spent many years working with manufacturers in a consulting role before shifting his attention to growing his expertise in State Price Transparency Reporting at IntegriChain. His background includes successful project execution in many areas such as system implementation, managed care contracting, chargeback validation, and government pricing. He is currently overseeing a dedicated team of SPTR resources. John looks to expand the offering and opportunities to support manufacturers in the complex waters of compliance.
Government Pricing May 26, 2022 The Nuance and Necessity of Timely State Price Transparency Reporting 4 Minute Read