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Committee hears competing pharmacy views on biosimilars and pharmacist substitution
Summary
Engrossed Substitute Senate Bill 5,594 would add biosimilars to provisions affecting step therapy and pharmacist substitution; supporters say it increases use of lower‑cost biologics, pharmacists warn a patient-cost substitution requirement is impractical without claims-level data.
Engrossed Substitute Senate Bill 5,594 would add biosimilars to two existing provisions that apply today to interchangeable biological products and generics: it would allow a health carrier to require a patient to try a biosimilar prior to covering an equivalent branded biologic beginning Jan. 1, 2026, and it modifies pharmacist substitution rules for therapeutically equivalent drugs and interchangeable biological products.
Kim Weidner, committee staff, summarized federal FDA distinctions between biosimilars and interchangeable biological products and said the bill does not currently require automatic biosimilar substitution; rather, the measure clarifies how biosimilars are treated in step-therapy and substitution provisions.
Jennifer Ziegler of the Association of Washington Healthcare Plans testified in favor, saying "biosimilars do create an opportunity" to reduce prescription drug costs, which she described as a major driver of premiums. Ziegler noted the bill was negotiated with BIO and the Department of Health and reflects a narrow, state‑level change consistent with other states.
Dr. Jenny Arnold, CEO of the Washington State Pharmacy Association and a pharmacist, testified with concerns. She said existing law (cited in testimony as RCW 69.41.125) already requires pharmacists to substitute an interchangeable biologic in some circumstances and that the bill's proposed requirement to substitute when the interchangeable biologic lowers a patient's out‑of‑pocket cost is difficult to implement because pharmacies generally cannot determine a patient's exact out‑of‑pocket cost at the point of dispensing without running a claims transaction.
Witnesses and stakeholders asked the committee to remove or amend the pharmacist interchange requirement to avoid operational burdens, while supporting the bill's goal of increasing biosimilar use. The committee did not take a vote at the hearing; staff and stakeholders indicated further amendment work would continue.
