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REFERENCE TITLE: prescription drugs; diabetes; reports |
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State of Arizona Senate Fifty-fourth Legislature Second Regular Session 2020
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SB 1549 |
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Introduced by Senators Rios: Steele
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AN ACT
aMENDING TITLE 36, Arizona Revised Statutes, BY ADDING CHAPTER 16; RELATING TO PRESCRIPTION DRUGS.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 36, Arizona Revised Statutes, is amended by adding chapter 16, to read:
CHAPTER 16
PRESCRIPTION DRUGS
ARTICLE 1. GENERAL PROVISIONS
36-1801. Definitions
In this article, unless the context otherwise requires:
1. "Department" means the department of health services.
2. "Manufacturer" has the same meaning prescribed in section 32‑1901.
3. "Pharmacy benefit manager" has the same meaning prescribed in section 20‑3321.
4. "Wholesale acquisition cost" means the manufacturer's list price for a prescription drug to wholesalers or direct purchasers in the United States, not including any discounts, rebates or reductions in price, as reported in wholesale price guides or other publications of drug pricing data.
36-1802. Prescriptions drugs; essential diabetes treatment; lists
On or before February 1 of each year, the department shall compile:
1. A list of prescription drugs that the department determines to be essential for treating diabetes in this State and the wholesale acquisition cost of each drug on the list. The list shall include all forms of insulin and biguanides marketed for sale in this state.
2. A list of prescription drugs described in paragraph 1 of this section that have been subject to an increase in the wholesale acquisition cost of a percentage equal to or greater than either:
(a) The percentage increase in the consumer price index, medical care component during the immediately preceding calendar year.
(b) Twice the percentage increase in the consumer price index, medical care component during the immediately preceding two calendar years.
36-1803. Drug manufacturers; reports; wholesale acquisition cost
A. On or before April 1 of each year, each manufacturer of a prescription drug that appears on the most current list compiled pursuant to section 36‑1802, paragraph 1 shall prepare and submit to the department, in a form prescribed by the department, a report that includes:
1. The costs of producing the drug.
2. The total administrative expenditures relating to the drug, including marketing and advertising costs.
3. The profit the manufacturer earned from the drug and the percentage of the manufacturer's total profit for the period during which the manufacturer marketed the drug for sale that is attributable to the drug.
4. The total amount of financial assistance the manufacturer provided through any patient prescription assistance program.
5. The cost associated with coupons provided directly to consumers and for programs to assist consumers in paying copayments, and the cost to the manufacturer attributable to the redemption of those coupons and the use of those programs.
6. The wholesale acquisition cost of the drug.
7. Any increase in the wholesale acquisition cost of the drug over the five years immediately preceding the date on which the report is submitted, including the amount of each such increase expressed as a percentage of the total wholesale acquisition cost of the drug, the month and year each increase became effective and any explanation for the increase.
8. The aggregate amount of all rebates the manufacturer provided to pharmacy benefit managers for sales of the drug within this state.
9. Any additional information prescribed in rule by the department for the purpose of analyzing the cost of prescription drugs that appear on the list compiled pursuant to section 36‑1802, paragraph 1, trends in those costs and rebates available for such drugs.
B. On or before April 1 of each year in which a drug is included on the list compiled pursuant to section 36‑1802, paragraph 2, each manufacturer of the drug shall submit to the department a report describing the reasons for the increase in the wholesale acquisition cost of that drug. The report shall include:
1. A list of each factor that contributed to the increase.
2. The percentage of the total increase attributable to each factor.
3. An explanation of the role of each factor in the increase.
4. Any other information prescribed in rule by the department.
36-1804. Pharmacy benefit managers; reports; rebates; exception
A. Except as otherwise provided in subsection B of this section, on or before April 1 of each year, each pharmacy benefit manager shall submit to the department a report that includes all of the following:
1. The total amount of all rebates the pharmacy benefit manager negotiated with manufacturers during the immediately preceding calendar year for prescription drugs included on the list compiled by the department pursuant to section 36‑1802, paragraph 1.
2. The total amount of all rebates described in paragraph 1 of this subsection that the pharmacy benefit manager retained.
3. The total amount of all rebates described in paragraph 1 of this subsection that were negotiated for purchases of such drugs for use by:
(a) Medicare recipients.
(b) Medicaid enrollees.
(c) Persons covered by third parties that are governmental entities that are not described in subdivision (a) or (b) of this paragraph.
(d) Persons covered by third parties that are not governmental entities.
(e) Persons covered by a plan described in subsection B of this section to the extent required by a contract entered into pursuant to subsection C of this section.
B. Except as otherwise provided in subsection C of this section, the requirements of this section do not apply to the coverage of prescription drugs under a plan that is subject to the Employee Retirement Income Security Act of 1974 or any information relating to such coverage.
C. A plan described in subsection B of this section, by contract, may require a pharmacy benefit manager that manages the coverage of prescription drugs under the plan to comply with the requirements of this section.
36-1805. Department analysis; annual report
On or before June 1 of each year, the department shall analyze the information submitted pursuant to sections 36‑1803 and 36‑1804 and compile a report on the price of the prescription drugs that appear on the most current lists compiled by the department pursuant to section 36‑1802, the reasons for any increases in those prices and the effect of those prices on overall spending on prescription drugs in this state. The report may include, without limitation, opportunities for persons and entities in this state to lower the cost of prescription drugs to treat diabetes while maintaining access to such drugs.