Committee backs NADAC-plus-dispense fee floor to shore up local pharmacies

Representative Jasper introduced HB810 (LC461418S) as a measure to create a reimbursement floor for pharmacies tied to the National Average Drug Acquisition Cost (NADAC) plus a dispense fee. Supporters said opaque PBM (pharmacy benefit manager) practices and later clawbacks frequently reimburse pharmacies below cost and are contributing to pharmacy closures. The bill’s text as discussed in committee treats many categories of fees and lists a dispense fee of $10.64 to be added to NADAC in reimbursement calculations.

Stephanie Katz (National Association of Chain Drug Stores) walked the committee through the mechanics: NADAC would be the ingredient cost benchmark and the dispense fee compensates pharmacists for counseling, checking drug interactions and overhead. Independent pharmacists described narrow margins and cited examples of stores operating at a loss without a dispense fee.

Health-plan representatives and PBM associations urged caution. Jesse Wethington (Georgia Association of Health Plans) asked for a later effective date tied to plan-year cycles and requested an explicit ERISA carve-out for self-funded plans; he warned the change could shift costs to insureds and employers. Michael Power (Pharmaceutical Care Management Association) said similar policies in other states have increased patient out-of-pocket costs at the counter and opposed the bill as written.

Sponsor and witnesses disputed whether the policy would necessarily raise costs for patients: testifiers said vertical integration and current pricing distortions already shift money in opaque ways and that a floor could stabilize pharmacy access while reducing overpayments for specialty drugs. After extended testimony and questions, a member moved and the committee voted by voice to report HB810 out with a do-pass recommendation.