Matzie bill to lower prescription drug costs passes legislature, heads to governor

Aimed at bringing transparency to pharmacy benefit manager practices

HARRISBURG, Nov. 20 – Pennsylvania’s drug consumers and taxpayers are on the verge of a major victory after final passage of state Rep. Rob Matzie’s bill to hold pharmacy benefit managers accountable for predatory practices that are gouging patients, wasting taxpayer dollars and driving mom-and-pop pharmacies out of business.

Matzie, D-Beaver/Allegheny, said he introduced H.B. 941 together with state Rep. Doyle Heffley, D-Carbon, to bring transparency to questionable PBM pricing practices in the state’s Medicaid program and that the bill — which passed the state House in November – is now headed to the governor’s desk.

“This bill is a big victory for Pennsylvania’s taxpayers, local pharmacies and anyone who takes prescription medicine,” said Matzie, who is House Democratic chair of the bicameral, bipartisan Community Pharmacy Caucus. “With the power to decide which drugs are covered by insurance and how much to reimburse the pharmacies that fill those prescriptions, PBMs wield a huge amount of power, but for years, they have operated below the radar, with little or no scrutiny. All that is about to change.

“My bill would shed light on how PBMs are making key decisions, including how they determine price spreads – the difference between how much the state pays them for a drug and how much they reimburse the pharmacies that fill those prescriptions – and how they select which drugs make it onto the formulary list of insured medications, for which they receive manufacturer rebates.

“For too long, those decisions and calculations have been shrouded in secrecy, and it’s the people of Pennsylvania who are losing. Each year, we see drug prices rising and the beloved mom-and-pop pharmacies so important to our community shutting their doors because they can’t compete with large chain pharmacies.

“It’s time for a reckoning, and for the state’s consumers and taxpayers to see whether PBMs are making these decisions in the consumer’s best interests or to help line their own pockets.”

The House first passed the bill in November 2019. The Senate then passed an amended version of the bill this October. The House unanimously concurred in Senate amendments on Nov. 18 and again amended the bill, and the Senate today concurred in those amendments. The bill has been signed in the House and now heads for the governor’s desk.