Pharmacy benefit managers and health carriers required to include lower-cost drugs in their formularies, and formulary structure and formulary tiering for each health plan required to give preference to the drug with the lowest out-of-pocket cost to the patient.

This bill requires Minnesota health plans and pharmacy benefit managers to include lower-cost generic or biosimilar drugs in their drug lists (formularies) when equivalent options cost less than current choices. It mandates that formulary tiers and structure must prioritize the drug with the lowest out-of-pocket cost for patients (including co-pays and coinsurance), without restricting access to that option. Health plans must immediately add newly approved generic or biosimilar drugs to their formularies if they cost less than existing covered options. This directly affects patients by reducing their medication costs and health plans/carriers by changing how they manage drug coverage.