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Committee hears hours of testimony on 'white bagging' and 'brown bagging' for clinician‑administered drugs; amendment prepared
Summary
Senate Bill 256 — aimed at curbing 'white bagging' and 'brown bagging' practices that can route clinician‑administered specialty drugs outside normal provider procurement — drew extensive testimony on patient safety, hospital pharmacy burden and costs; negotiators said a replacement amendment would be circulated for further review.
Senate Bill 256 — a bill to regulate so-called “white bagging” and “brown bagging” of clinician‑administered specialty drugs — drew extended testimony from hospitals, pharmacists, patient advocates, insurers and small‑business groups at the Senate Health and Human Services Committee.
Sponsor Senator Tim McHugh framed the bill as a patient‑safety and cost‑control measure designed to prevent specialty infusion drugs (for example, chemotherapy and other biologic infusions) from being shipped directly to patients’ homes (brown bagging) or directly to sites of care without provider involvement (white bagging). “We don’t want the health plan or some arbitrary disconnected pharmacy contractor to drop a shipment of a critical infusion drug at your house without you knowing it’s coming,” McHugh said. He described an amendment modeled on language adopted in other states and on federal guidance that would limit white/brown bagging but preserve clinical exceptions when clinicians and patients jointly determine alternative procurement is the only option.
Hospital Association testimony (Kathy Bazaroth Thunberg, New Hampshire Hospital Association) stressed safety and inventory burdens on hospital pharmacies: white‑bag shipments require hospitals to receive, inventory and store medications they did not purchase and may not be able to use if a patient’s clinical status changes. Pharmacy and nursing witnesses (Tanya Carlton, New Hampshire Society of Health System Pharmacists) described costly wasted medications after drugs arrive late, are damaged in shipment, or cannot be used because patient labs or condition change at the time of administration. Representative Julie Miles, a practicing registered nurse and co‑sponsor, urged the committee to protect patients from the logistical burdens of transporting critical drugs and from care delays.
On the payer side, DJ Bettencourt, commissioner of the New Hampshire Insurance Department, said the department’s staff would help refine statutory language and offered to update the fiscal analysis to reflect the amendment. Industry representatives, including the Pharmaceutical Care Management Association (Curtis Berry) and large carriers represented by Sabrina Dunlap (Anthem) and Paula Rogers (AHIP), warned against unintended cost shifts and urged careful calibration. PBM and plan representatives said they can help design payment mechanisms that preserve access without raising premiums unduly; one witness referenced research showing clinician‑administered drugs frequently cost more in hospital settings than in outpatient infusion centers.
Business and employer groups (John Reynolds, NFIB) supported the amendment as delivering value and guarding against higher costs to employers. Several speakers representing pharmacies, hospitals and insurers said they had not had time to review the full replacement amendment introduced shortly before the hearing and requested an opportunity to comment further.
No committee vote was taken; the sponsor and multiple stakeholders said they would continue to negotiate amendments. The committee did not take executive action on SB 256 at the hearing.
Ending: The committee deferred action to allow stakeholders to review a replacement amendment and requested updated fiscal analysis from the insurance department.
