John Curry comments on the "Maine Law" re: PBM transparency

From John Curry, March 8, 2007
Subject: The "Maine Law" re: PBM transparency

Gee, I wish the "forward thinking" Ohio legislators would have the political courage to introduce a bill which would parallel the "Maine Law" as it relates to transparency of pharmacy benefits managers. The temporary injunction (sought by Big Pharma) against this Maine Law has now been suspended. Below is a summary of the Maine Law. John

As a general rule the amount of fees and rebates that a manufacturer pays to a PBM has been kept "secret." These fees and rebates improve the chances of a particular drug to be sold by a PBM. Maine was the first state to introduce legislation to force the PBMs to disclose these payments. Several other states have now followed Maine in enacting similar legislation. The law became effective in Maine in September 2003. In granting the temporary injunction against compliance with the law, the judge said that PCMA "has demonstrated substantial likelihood of success" in its argument that the Maine law is preempted by the federal benefits law, the Employee Retirement Income Security Act of 1974.

The Maine law also requires the PBMs to pass along to their clients the volume-based discounts they get from a drug maker. The law also requires the PBM to get the physician's approval if a prescribed medication is to be switched. It also requires the PBM to tell the individual and the health-insurance provider the cost of the prescribed drug and the drug that the PBM wants the patient to be switched to. Violations would be punishable by a fine for as much as a $10,000 per violation."