MADISON, WI (September 12, 2019) – The Wisconsin Pharmacy Patient Protection Coalition (WPPPC), which represents patients, health groups, pharmacists and others negatively impacted by Pharmacy Benefit Managers (PBMs), today announced its formation to support legislation to fix Wisconsin’s PBM problem. Senate Bill 100 and Assembly Bill 114 will hold PBMs accountable by requiring them to register with the state; establishing price transparency requirements and eliminating intimidating gag clause provisions in PBM contracts with pharmacies, pharmacists, or health benefit plan sponsors. The bills also require PBMs to ensure patients are not denied coverage during a plan year if their medication/device was covered when the participant enrolled or renewed their coverage – often called non-medical switching.
“What this legislation does is to finally hold the whole PBM industry accountable for their secretive actions that have hurt our state’s most vulnerable patients by forcing them to unknowingly pay high prices for prescriptions,” said Rob Gundermann, chair of the WPPPC and president and executive director of the Coalition of Wisconsin Aging and Health Groups. “PBMs have done everything possible to keep their actions secret as they pocket savings meant for patients. These middlemen between insurers and pharmaceutical companies were supposed to reduce patient costs and ensure quality medication use, but some got greedy in the process. Bad actors even created contractual gag clauses forbidding pharmacists from telling their patients what’s happening. That’s created harmful health situations for patients and our coalition is saying ‘we’ve simply had enough and want this to stop.’”
The coalition also unveiled a petition of nearly 11,000 signatures from Wisconsin patients calling on legislators to fix harmful PBM practices. Legislation has been introduced in all 50 states to regulate and require PBM transparency in the prescription process, and laws have been enacted in 33 states. Neighboring states like Minnesota, Iowa, Illinois, Michigan and many others have reported PBMs overbilling hundreds of millions of dollars to patients.
“PBMs and their alliance with insurers have created barriers for small pharmacies like ours to serve patients in rural communities and they know it,” said Dan Strause, owner of Hometown Pharmacy with more than 40 Wisconsin stores. “We’ve seen patients suffering because they can’t afford or get access to the prescriptions they need, all because the PBMs have manipulated prices and delivery options behind the scenes. People need to know what is happening and this legislation works to correct many of the problems our customers and pharmacists are experiencing.”
More than 95 cosponsors have signed onto the bi-partisan legislation supporting regulation of the PBMs. Primary sponsors of the bills include Senator Jon Erpenbach (D-Middleton) and Senator Roger Roth (R-Appleton), and Representative Michael Schraa (R-Oshkosh) and Representative Debra Kolste (D-Janesville). To view both bills and their support go to SB100 https://tinyurl.com/y484vh9s AB114 https://tinyurl.com/y223cdpc.
“This is common sense legislation that puts patients and pharmacists first while holding PBMs accountable,” said Danielle Womack, vice president of public affairs at the Pharmacy Society of Wisconsin. “Once passed into law, these regulations will create greater transparency and prescription access at pharmacy counters for patients statewide. It is time to stop the harmful practices of PBMs and this legislation will help do that.”
Those interested in supporting the Wisconsin Pharmacy Patient Protection Coalition can follow the group on Twitter @WI4Patients and also view this video that further explains the PBM process https://tinyurl.com/y3el3gp7 Everyone is encouraged to send an email and/or call your local legislators https://maps.legis.wisconsin.
Members of the Wisconsin Pharmacy Patient Protection Coalition include: American Cancer Society Cancer Action Network; American Diabetes Association; AIDS Resource Center of Wisconsin; Coalition of Wisconsin Aging and Health Groups; Epilepsy Foundation; Great Lakes Hemophilia Foundation, Hometown Pharmacy; Lupus Foundation of America, Wisconsin Chapter; National Infusion Center; National Multiple Sclerosis Society; Pharmacy Society of Wisconsin; Wisconsin Alliance for Women’s Health; Wisconsin Medical Society; and Wisconsin Rheumatology Association.
