The West Virginia Legislature has passed a bill that will lower prescription drug costs for individuals on commercial insurance plans.
If signed by Gov. Jim Justice, West Virginia will be the first state in the country to require drug discounts or rebates, negotiated by insurance companies for patients, to actually be passed on to patients.
House Bill 2263 might do more than any other bill to reduce the cost of medicines for West Virginians and better enable them to maintain their prescription drug therapy, sustain their health care routine and keep them active for work and the enjoyment of life.
Yet, I am sure you haven’t heard a word about it.
Let’s start at the beginning.
You might be surprised to know that insurance companies and pharmacy benefit managers negotiate significant rebates on your prescription drugs. These come from rebates that are paid by the drug companies to the benefit managers, but you never see them.
The rebates are never passed on to the intended recipient — you, the customer.
Pharmacy benefits managers are the middlemen. They are hired by insurance companies to manage what medicines you have access to. This is called the “preferred drug list.” To make the list, the pharmaceutical industry must provide very significant discounts and rebates. The discounts usually amount to about 50% off the list price.
But the rebates and discounts never make it to you at the pharmacy counter. The middlemen in this scenario keep the discounts, and you end up paying the full list price until your insurance kicks in after you have reached your deductible.
Simply put, HB 2263 will require insurance companies and benefits managers to share the savings they receive in the form of rebates from drug manufacturers.
As a business owner, I’ve never had a conversation with an insurance provider about getting a lower insurance premium because they negotiated significant drug rebates.
One of our nation’s largest health care providers, UnitedHealth, implemented a program similar to HB 2263 in 2018. While implementing its program of passing on a portion of the rebate money to patients, the company announced that patients have saved an average of $130 per prescription. And because the program is cutting out-of-pocket patient costs, medication adherence has improved up to 16%, depending upon the plan design.
West Virginia is on a path to replicate this kind of successful benefit for patients in our state. This is a remarkable outcome for many West Virginians with chronic conditions they must combat regularly with medication.
As the coordinator for the Charleston Parkinson’s Support Group, I urge Gov. Justice to join the West Virginia Legislature’s vote and sign into law HB 2263.
This is an opportunity for West Virginia to lead the country in lowering prescription drug prices for many of its residents.
As Justice has often said: “The entire world is watching the good things that are happening in West Virginia.”
Let’s add HB 2263 to the list of good things and do something no other state has done to help reduce prescription drug costs for the average person. By signing this bill, Justice will help thousands of our friends and neighbors afford their prescription drugs. It is nothing short of remarkable.