Healthcare (Prescription Drugs)

HB 1198 requires Tennessee health insurers and TennCare to allow patients to try biosimilar drugs (cost-effective copies of brand-name medications) before covering the original branded drug. It amends state law to permit health carriers to mandate a biosimilar trial for equivalent branded prescriptions, removing prior requirements for generic drug trials. The bill also directs TennCare’s pharmacy committee to consider biosimilar drugs when recommending medications for the state’s preferred drug list. These changes aim to reduce prescription drug costs by increasing biosimilar adoption, as stated in the bill’s legislative findings.

SB 436 requires Tennessee's Medicaid program (TennCare) to consider using biosimilar drugs - cost-saving, FDA-approved versions of biologic medications - as part of its drug coverage strategy. It also allows health insurers to require patients to try a biosimilar before covering a branded drug, and directs the state's pharmacy advisory committee to factor biosimilar use into recommendations for the state drug formulary. The bill amends multiple Tennessee Code sections governing drug coverage, pharmacy practices, and formulary decisions. These changes aim to reduce prescription drug costs by expanding the use of biosimilars while maintaining FDA safety and efficacy standards. The bill directly affects TennCare patients, health insurers, and the state's drug formulary decision-making process.