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Panel approves amendment to biosimilar coverage bill after debate over WAC vs. net cost reporting
Summary
The committee adopted amendments to House Bill 870 requiring insurers to report wholesale acquisition cost and a defined net cost per NDC and allowed regulators to accept net‑cost logic for formulary placement with written notice; the bill was reported favorably as amended.
House Bill 870, introduced in the House and presented in committee by Brett Mishlin of the Association for Accessible Medicines, would require insurers and PBMs to cover lower‑priced generics or biosimilars when they are available and to avoid using utilization management to block access to lower‑cost alternatives.
Mishlin told the committee the bill uses the wholesale acquisition cost (WAC) as a transparent, industry‑accepted number to compare prices and promote competition. "This bill really does two simple things… then that insurance company or the PBM should cover it at a lower cost to the…
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