BARBOURSVILLE, W.Va. – Delegate Evan Worrell, R-Cabell, today said a bill from the 2019 regular session is now leading the way to ensure West Virginians have access to low-cost prescription medications.
During the 2019 Legislative Session, the Legislature passed and Gov. Jim Justice signed Senate Bill 489, which established regulatory standards for pharmacy benefit managers (also known as PBMs) under the oversight of the West Virginia Offices of the Insurance Commissioner. The bill also contained a succinct, but extraordinarily important provision which protects the 340B Drug Pricing Program.
“This federal program is rarely discussed, but its impact is felt throughout the Mountain State,” Delegate Worrell said.
The 340B program enables safety net health care providers such as federally qualified health centers (“FQHCs”) and certain hospitals – referred to as “covered entities” – to pay reduced prices for drugs.
Drug manufacturers participating in state Medicaid programs agree to provide drugs to covered entities at significantly reduced prices. The dollars saved are used to reach underserved patients and provide comprehensive services such as uncompensated care, payment assistance, transportation, and other valuable services.
According to the West Virginia Primary Care Association and West Virginia Independent Pharmacy Association, the 340B program’s impact in West Virginia is enormous, with more than $250 million dollars per year directed back into programs for rural, underserved West Virginians at health centers and hospitals statewide.
“Health care providers stressed to policymakers that these dollars needed protection from large pharmacy benefit managers, and the Legislature responded immediately, and in a big way,” said Matt Walker, executive director of the WVIPA and representative for the WVPCA.
Walker said since this new law became effective in February, he has spoken with more than a dozen national organizations and states, all intending to advocate for laws similar to West Virginia’s.
“Senate Bill 489 was a first-of-its-kind bill,” Walker said. “Several other states have passed similar measures, but none are as strong as West Virginia’s, which is impressive. Thankfully, the West Virginia Legislature acted fast to take care of patients and health care providers that offer safety net services.”
“The 340B program’s impact is felt nationwide, but West Virginia has chosen to protect its 340B program with the nation’s strongest 340B law,” Delegate Worrell said. “You read that right – West Virginia’s law is number one, following discussion and analysis by several national policy and 340B pharmacy groups.”
In late 2018, pharmacy benefit managers announced to 340B covered entities that they intended to reduce reimbursement.
“The policy response in many states was swift and certain – especially in West Virginia,” Delegate Worrell said. “West Virginia law prohibits PBMs and insurance companies from reducing reimbursement to 340B covered entities to rates lower than other pharmacies.
“This is good for patients, pharmacies, and West Virginia’s health care system as a whole,” Delegate Worrell said. “The West Virginia Legislature got this issue exactly right, and we’re the first in the nation to do so.”