Healthcare (Prescription Drugs)

HB 919 requires pharmacy benefit managers (PBMs) in Louisiana to reimburse pharmacies at least the National Average Drug Acquisition Cost (NADAC) plus the state's professional dispensing fee per prescription, with a minimum $12 per prescription. It prohibits PBMs from owning or contracting with pharmacies (including subsidiaries) and mandates annual transparency reports detailing foreign subsidiaries and financial arrangements with drug manufacturers. PBMs violating these rules face fines up to $100,000 per violation for executives, with unlimited liability for large PBMs ($500M+ revenue). The law applies retroactively to prescriptions filled between January 1, 2025, and December 1, 2025, and becomes fully effective for new requirements in 2027. These provisions directly affect pharmacies, pharmacists, and PBMs operating in Louisiana.

SB 381 (Louisiana) regulates pharmacy benefit managers (PBMs) by requiring them to pass all drug manufacturer rebates directly to health plans as lower premiums or reduced patient costs, rather than keeping them. It prohibits PBMs from withholding rebates to exclude generic or cheaper drugs from formularies and bans requiring patients to use more expensive brand-name drugs when cheaper alternatives exist. The bill also mandates a 60-day transition period for patients when a drug is removed from a formulary, ensuring continuity of care during plan changes. These provisions directly affect PBMs, health insurers, pharmacies, and patients in Louisiana by increasing transparency and reducing out-of-pocket costs. The bill is pending legislative action as of its prefiling date.

HB 277 requires drug manufacturers and marketers to include specific price information in educational or promotional materials provided to healthcare providers. The bill mandates that these materials disclose the average wholesale cost for a 30-day supply (or adjusted duration for shorter treatments) and whether a biosimilar or generic alternative exists for the same condition. This directly affects pharmaceutical companies and marketing entities targeting doctors. Violations would be enforced under Louisiana’s consumer protection laws, but the bill does not regulate actual drug prices or require discounts.

SB 387 amends Louisiana law to regulate pharmacy benefit managers (PBMs), directly affecting PBMs, local pharmacies, health insurers, and patients. It establishes new definitions (like "Maximum Allowable Cost List" and "Effective rate pricing"), requires PBMs to provide transparent compensation and services to enrollees and providers, and creates a private right to sue for violations. The bill also mandates audits of PBM practices, sets penalties for noncompliance, and repeals outdated provisions. These changes aim to increase transparency and accountability in how PBMs handle prescription drug pricing and reimbursements within Louisiana.

HB 866 prohibits pharmacy benefit managers (PBMs) and managed care plans in Louisiana from paying community pharmacies less than specific benchmarks for prescription drugs. It requires reimbursements to be at least the National Average Drug Acquisition Cost (NADAC) plus Louisiana's professional dispensing fee, or an approved alternative benchmark, and bans practices like "spread pricing" and "steering." The bill mandates "pass-through pricing," ensuring pharmacies receive payments directly without PBMs or plans keeping the difference. This directly affects Louisiana pharmacies and PBMs/managed care plans operating in the state, with violations subject to fines of $100,000+ per incident.