Committee advances bill to require quicker formulary placement for lower-cost generics and biosimilars
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Summary
House Bill 870, sponsored by Rep. Jim Turner, was reported with amendments after testimony from generic/biosimilar manufacturers urging faster market share for lower-cost options and insurers warning that using WAC rather than net price could increase premiums for fully insured members.
Representative Jim Turner told the House Insurance Committee that House Bill 870 is intended to make lower-cost generics and biosimilars accessible to patients by requiring insurers and PBMs to place those products on lower-cost formulary tiers and by prohibiting certain utilization-management barriers.
Brett Michelin of the Association for Accessible Medicines testified in support, citing insulin and Humira as examples where biosimilars or generics have not captured expected market share despite large discounts. "When a drug is available at a lower cost, it should be available to patients at a lower cost," Michelin said, urging tier placement that reduces patient co-pay or share-of-cost.
Louisiana Blue's pharmacy lead, Malam Ford, testified in opposition, arguing the bill's reliance on wholesale acquisition cost (WAC) rather than net cost would force coverage of products that are more expensive to plans after manufacturer rebates and discounts are applied. Ford said Louisiana Blue already covers many generics and biosimilars and warned that the proposed WAC trigger could increase premiums for fully insured members. "What matters to us is the net cost," Ford said, adding that mandatory placement based on WAC could raise costs for premium-paying members.
Committee members asked whether parts of the draft would be preempted for self-funded ERISA plans, and Representative Jordan cautioned that specifying tiering could present legal challenges. Turner and witnesses said they would continue negotiations with insurers and manufacturers to resolve net-versus-WAC language and other drafting issues.
After back-and-forth on technical points and a commitment to additional stakeholder work, the committee reported HB 870 with amendments by voice action with no objection. The sponsor said he had engaged with Louisiana Blue and expected further drafting adjustments.
The committee action moves HB 870 to the full House; proponents say the bill aims to accelerate biosimilar and generic uptake to lower patient costs, while insurers urge careful drafting to avoid unintended premium impacts.
