MADISON, Wis. (WRN) — The clock is running on legislation that would reform how pharmacy benefit managers operate and protect patients from sudden drug cost hikes.
Bill Schmidtknecht’s 22-year-old son Cole died after a PBM copay accumulator drove the price of his asthma inhaler to $500 — which he was unable to afford.
“For patients with asthma, diabetes, heart disease, mental health conditions, a delay isn’t an inconvenience. It’s a serious safety risk. Cole’s Act makes it clear no patient should ever be forced to a mail order pharmacy,” Schmidtknecht said.
The legislation requires PBMs to allow patients to use any licensed pharmacy without facing penalties. It also requires PBMs to pay pharmacists a dispensing fee at least equal to what the state pays through Medicaid. The Senate version cleared a committee on a unanimous vote in August, but the bill hasn’t had a hearing in the Assembly. Rob Gunderman is with Wisconsin All Copays Count.
“We’ve got basically a month to get this done, so we need that hearing in January and we need to get it out of committee in January, so we have an opportunity to get this to the floor,” Gunderman said.