The New Jersey House of Representatives convened on December 9, 2024, to discuss proposed amendments to legislation concerning pharmacy benefits managers (PBMs) and health benefits plans. The meeting highlighted significant concerns from industry representatives regarding the potential financial implications of the amendments.

Key discussions centered around proposed committee amendments that would require PBMs to disclose fees paid to third-party brokers and adjust the definition of health benefits plans to include self-insured plans. Additionally, the amendments aim to replace references to independent pharmacies with those to unaffiliated pharmacies.

Matt Greller, representing the Pharmaceutical Care Management Association (PCMA), expressed strong opposition to the bill, citing three main concerns: process, cost, and who benefits from the legislation. Greller argued that the committee should delay further action for 30 days to allow for the implementation of a comprehensive PBM law passed in the previous session, which is set to take effect on January 10, 2025. He warned that the new legislation could lead to significant cost increases, estimating over $491 million in lost savings and more than $5 million in additional costs in the first year alone.

Heather Cascone, also from PCMA, echoed these concerns, stating that the bill, while named for the protection of patients and providers, primarily benefits drug manufacturers and pharmacies. She emphasized that the amendments could lead to higher premiums for patients and reduce the bargaining power of PBMs, ultimately resulting in increased costs for consumers.

The committee members were urged to consider the broader implications of the proposed changes, particularly in light of the recent PBM law. The discussions underscored the ongoing debate over the balance between regulating pharmacy benefits and ensuring affordable healthcare for New Jersey residents. The committee's next steps remain to be determined as they weigh the feedback from industry stakeholders against the intended goals of the legislation.