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Board considers single-PBM recommendation and broader legislative proposals
Summary
Members discussed recommending a single pharmacy benefit manager for Medicaid and managed care to increase transparency, plus other policy options for the board's 2025 legislative report. Supporters cited access and transparency; others warned the board lacks statutory scope and stakeholder representation for full system redesign.
At its Sept. 17 meeting the Oregon Prescription Drug Affordability Board began narrowing policy ideas for the board’s 2025 annual legislative recommendations, with several members urging the panel to propose bold changes to state pharmacy purchasing and PBM oversight.
Board member John Murray proposed a recommendation to the Legislature to institute “one PBM” for all Medicaid and managed care patients in Oregon, selected through a bidding process intended to emphasize efficiency, transparency and uniform dispensing fees. “Institute 1 PBM for all Medicaid and managed care patients in Oregon to be selected through a bid process, which emphasizes efficiency, reduce taxpayer costs, access for all Oregonians, and maximum transparency,” Murray said, and referenced examples in other states.
Several board members, including Dan Kennedy and Chris Layman, voiced support for exploring the idea and for tying any PBM policy to verifiable pharmacy cost figures and appropriate dispensing fees. Chair Shelley Bailey and others noted that some states have pursued similar reforms and that prior PDAB recommendations (for example on insulin copay caps) had led to statutory change.
Vice Chair Amy Burns cautioned that many member proposals focused on Medicaid and that the board’s current statutory makeup and expertise may not be sufficient to redesign Medicaid pharmacy programs without adding voices representing Medicaid administration and CCOs. Burns urged careful crafting of any recommendation and, if necessary, a companion recommendation to revise board composition or statutory authority.
Courtney Whitlock said staff will collect the proposed concepts and return draft recommendation language in time for the board’s November–December review cycle. The board agreed to continue refining the recommendations and to consider the policy language at the next meeting before finalizing the 2025 report for submission to the Legislature in December.
The discussion did not produce a final vote on any specific legislative proposal; staff will circulate draft language and background for future consideration.
