State Representative Tom Oliverson, M.D. has filed major legislation aimed at lowering costs for patients by providing needed transparency and oversight in the prescription drug market.
Rep. Oliverson (R-Cypress) filed HB 2231 which seeks to lower health care costs by regulating the business practices of pharmacy benefit managers (PBMs) to create a level playing field in the healthcare industry.
As powerful middlemen between drug manufacturers and health insurance plans, PBMs engage in a complex system of rebates and negotiations to save health plans money on prescription drugs and to reimburse pharmacies for the cost of dispensing a drug. Through this system, PBMs purport to reduce costs, but perverse incentives often result in higher markups that the consumer ultimately must pay.
“The opaque way PBMs control the market have driven up costs.” Rep. Oliverson said. “We owe it to the Texans struggling with prescription drug costs to combat PBMs’ manipulation of the prescription drug market.”
PBMs have come under increased scrutiny across the country over the last few years. The Trump administration recently announced new rules intending to ensure rebates now paid to PBMs are passed through to patients. A number of states have also been looking closely at drug rebates and the amount of dollars that flow to PBMs through programs such as Medicaid.
“There’s an emerging consensus across the country that PBMs are taking advantage of lax oversight and complexities in the drug-pricing process,” Rep. Oliverson said. “It’s time for us to have that conversation in Texas.”