Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Prescription Rebates topic
No spam. Unsubscribe anytime.
Committee backs resolution asking PEHP to pass pharmacy rebates through at point of sale
Summary
Representative Thurston told the Health and Human Services Committee HCR 2 would direct PEHP to pass manufacturer rebates through to patients at the pharmacy, reducing the patient’s point-of-sale price.
Representative Thurston presented HCR 2, a concurrent resolution directing PEHP to pass pharmacy manufacturer rebates through to patients at the point of sale. He and PEHP representative Chet Loftus said the proposal would make the patient’s out‑of‑pocket price closer to the drug’s net cost by applying estimated rebates when the prescription is dispensed.
"Rather than patients having to pay an extra amount for that back end piece to happen, they just pay the regular price of a drug," Thurston told the committee. Chet Loftus of PEHP described prior use of the practice for insulin and EpiPens and said the agency has operational experience, though implementing the change broadly requires technical work with PBMs and pharmacies.
Committee members asked about the fiscal note and how the change would be funded. Thurston and PEHP staff said the change is self‑funding within each risk pool: rebates already collected on behalf of members would instead be distributed at dispensing, and PEHP estimated the per‑member per‑month cost to spread across the membership at about $2.84. Representative Eliason pressed on why the fiscal note showed zero state general fund impact; PEHP replied that the change reallocates existing rebate dollars within the group rather than requiring a new appropriation.
The committee adopted Amendment 1 (a technical update to the cost estimate) and then passed HCR 2 with a favorable recommendation by voice vote; the chair recorded the motion as unanimous. Committee discussion cited prior PEHP programs that reduced insulin costs at point of sale and estimated the total state impact at roughly $2 million under the assumptions presented.
The resolution directs PEHP to implement the pass‑through approach and asks the agency to report implementation details to the Legislature; no binding appropriation clause was attached to the resolution as presented.
