Matzie bill would bring transparency to pharmacy benefit manager practices

HARRISBURG, May 10 – Increasing transparency in pharmacy benefit manager pricing practices is the goal of legislation recently introduced by state Rep. Rob Matzie, D-Beaver/Allegheny.

Matzie said he introduced H.B. 941 with co-prime sponsor, state Rep. Doyle Heffley, D-Carbon, to address PBM practices in the state’s Medicaid program – in which nearly 90 percent of the state’s Medicaid patients are served by managed care companies that contract with PBMs.

“Greater transparency is essential because these third-party PBMs – which are charged with deciding what drugs will be covered and how much to reimburse pharmacies – wield a tremendous amount of power through their rate-setting, yet are operating with little transparency,” Matzie said. “At the same time, they are having a profound impact on small, independent pharmacies. 

“Over the past two years, I have been hearing increasing complaints from local pharmacies about how PBMs are slashing drug reimbursement rates, especially with regard to Medicaid patients. As these third-party companies set rates well below the costs paid by local pharmacies, these small, trusted businesses are being forced to close their doors. 

“The situation is threatening both the health of our local economy and the well-being of our area seniors, including some of our most vulnerable citizens who rely for their medications on these local neighborhood pharmacies. It’s time to do something about it.”

There are an estimated 900 independent pharmacies in Pennsylvania.