05/09/2024 05:15 PM Senate LABOR & COMMERCE

        HB 226-PHARMACIES/PHARMACISTS/BENEFITS MANAGERS                                                                     
                                                                                                                                
5:19:09 PM                                                                                                                    
CHAIR BJORKMAN announced the consideration of CS FOR HOUSE BILL                                                                 
NO. 226(L&C)"An Act relating to insurance; relating to pharmacy                                                                 
benefits  managers; relating  to dispensing  fees; and  providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
He noted  that the  companion bill, SB  121 was  previously heard                                                               
and  before the  committee for  consideration was  SCS CSHB  226,                                                               
work order 33-LS0955\H.                                                                                                         
                                                                                                                                
5:20:00 PM                                                                                                                    
CHAIR BJORKMAN opened public testimony on HB 226.                                                                               
                                                                                                                                
5:20:28 PM                                                                                                                    
DANIEL NELSON,  Director of  Pharmacy, Tanana  Chiefs Conference,                                                               
Anchorage, Alaska,  testified in  support of HB  226. He  said he                                                               
was an Alaskan  pharmacist for over 20 years and  the director of                                                               
pharmacy  for  the  Tanana  Chiefs   Conference  since  2007.  He                                                               
explained that  Pharmacy Benefit  Managers (PBMs)  were initially                                                               
created to  help rein in  prescription drug costs and  manage the                                                               
complex   reimbursement   environment  of   prescription   drugs.                                                               
Unfortunately,  a lack  of regulatory  and legislative  oversight                                                               
allowed  PBMs to  become vertically  and horizontally  integrated                                                               
oligopolies. He said  PBMs made an already complex  issue into an                                                               
utterly  illogical  world where  they  are  now  a, if  not  the,                                                               
primary driver of increasing prescription  drug costs in America.                                                               
He said this  was an issue he was very  passionate about, because                                                               
he  saw how  the many  problematic practices  of PBMs  negatively                                                               
impact clinical  outcomes for  patients, drive  prescription drug                                                               
costs up and  bankrupt Alaskan pharmacies through  a laundry list                                                               
of frankly  ludicrous business practices  designed with  the sole                                                               
intent of increasing PBMs' profit  margins and absolutely nothing                                                               
else. He said  he would not go  too far into the weeds  of HB 226                                                               
today, but  that the  bill was  a very modest  first step  in the                                                               
desperately needed arena  of PBM regulation and  reform. He urged                                                               
the committee to pass HB 226 out of committee today.                                                                            
                                                                                                                                
5:22:04 PM                                                                                                                    
BRANDY   SEIGNEMARTIN,   Executive  Director,   Alaska   Pharmacy                                                               
Association, Eagle River, Alaska,  testified in strong support of                                                               
HB 226 on behalf of the  Alaska Pharmacy Association. She said HB
  sought  to  address   anti-competitive,  unfair  and  opaque                                                               
business  practices  by  Pharmacy Benefit  Managers  (PBMs).  She                                                               
shared  new  data  from  a  first  of  its  kind  study  done  in                                                               
Washington State  that shed light on  the significant disparities                                                               
caused by  PBMs in the  employer and commercial  marketplace, the                                                               
sector HB 226 specifically applied  to. The study found that PBMs                                                               
were  steering patients  to their  own mail-order  pharmacies and                                                               
requiring the employer or plan sponsor  to reimburse the PBM at a                                                               
magnitude of  47 to 1400  times over acquisition costs  than they                                                               
reimburse   local  pharmacies.   She   emphasized  the   apparent                                                               
disparity and said the practice  resulted in erosion of the local                                                               
healthcare   infrastructure  and   the  closure   of  independent                                                               
pharmacies. She said HB 226  represented an important step toward                                                               
addressing these  harmful practices. She said,  while it wouldn't                                                               
solve  all the  issues,  it  would set  a  framework for  greater                                                               
oversight    and   accountability,    promoting   fairness    and                                                               
transparency  in  Alaska's health  care  industry.  She said  the                                                               
Alaska Pharmacy Association believed  HB 266 would help safeguard                                                               
local  pharmacies and  support better  health  care outcomes  for                                                               
patients. She thanked the committee  for their time and attention                                                               
and urged them to move HB  226 forward expeditiously to ensure it                                                               
would make it through this session.                                                                                             
                                                                                                                                
5:23:39 PM                                                                                                                    
ASHLEY  SCHABER,  Chair,  Alaska Board  of  Pharmacy,  Anchorage,                                                               
Alaska,  testified  on  behalf  of  the  Board  of  Pharmacy  who                                                               
unanimously supported HB 226. She said HB 226 would:                                                                            
   • promote choice for patients to access pharmacy services                                                                    
   • provide transparency                                                                                                       
   • protect safety and patient access to clinics who administer                                                                
     drugs                                                                                                                      
   • align with the Board's strategic plan                                                                                      
                                                                                                                                
MS. SCHABER  said passage of HB  226 would help build  the needed                                                               
foundation to  assure Alaska's pharmacies can  continue to safely                                                               
serve  Alaska   patients  throughout   the  state.   She  thanked                                                               
committee members for hearing HB  266 and urged their support and                                                               
quick passage [of HB 266].                                                                                                      
                                                                                                                                
5:24:31 PM                                                                                                                    
CHAIR BJORKMAN closed public testimony on HB 226.                                                                               
                                                                                                                                
5:24:39 PM                                                                                                                    
CHAIR BJORKMAN solicited the will of the committee.                                                                             
                                                                                                                                
5:24:41 PM                                                                                                                    
SENATOR GRAY-JACKSON moved to  report Senate Committee Substitute                                                               
(SCS) for  CSHB 226, work  order 33 LS0955\H from  committee with                                                               
individual recommendations and attached fiscal note(s).                                                                         
                                                                                                                                
5:25:11 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
5:25:20 PM                                                                                                                    
CHAIR  BJORKMAN reconvened.  He found  no objection  and SCS  FOR                                                               
CSHB 226(L&C)  was reported  from the  Senate Labor  and Commerce                                                               
Standing Committee.