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Committee hears debate on bill to pass most PBM rebates to patients at point of sale
Summary
Sarah Wood of the Diabetes Patient Advocacy Coalition told the committee that House Bill 413 would pass 85% of negotiated PBM rebates through to patients at the point of sale during deductible periods to lower out-of-pocket costs, particularly for insulin and other high-rebate drugs.
Sarah Wood, co-founder of Babbage and representing the Diabetes Patient Advocacy Coalition, presented House Bill 413 to the committee and described pharmacy benefit managers (PBMs) as intermediaries that negotiate manufacturer rebates to secure formulary placement. Wood said the bill would require PBMs and insurers to pass 85% of negotiated rebates through to patients at the point of sale during the deductible phase, immediately lowering out-of-pocket costs for many individuals with chronic illnesses such as diabetes.
Wood provided several numerical examples and statewide estimates cited in committee testimony: she said the average rebate on brand-name drugs is roughly 48 percent and that rebates for insulin sometimes exceed 80 percent; she said the measure would affect approximately 650,000 Kentuckians, including an estimated 351,979 individuals in the state insurance market…
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