2019 -- S 0137

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LC000385

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS--PRESCRIPTION

DRUG MARKETING

     Introduced By: Senators Miller, Satchell, Sosnowski, Goldin, and Valverde

     Date Introduced: January 24, 2019

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 27-20.8 of the General Laws entitled "Prescription Drug Benefits"

is hereby amended by adding thereto the following section:

     27-20.8-3. Fair marketing of prescription drugs.

     (a) Legislative purpose. Health insurance premiums are increasing in large part due to

prescription drug expenses. Drug manufacturers employ direct-to-consumer marketing strategies,

including coupons, discount cards, and similar offers, designed to conceal the true costs of high

priced drugs. Controlling the application of these marketing programs, especially when lower cost

alternatives are available, will help eliminate an expense that drives up the cost of health care for

Rhode Islanders. These marketing strategies and practices are prohibited for Medicare, Medicaid,

and other federally-funded programs because they increase the costs to those programs. Similar

protections should be provided for those paying the premiums for commercial coverage.

Furthermore, where the drug makers are willing to offer these ''discounts" to patients with

insurance, they should provide similar discounts to help those patients without coverage. This

section addresses those cost concerns.

     (b) A person who manufactures a prescription drug who offers or makes available to an

insured in this state any discount, repayment, product voucher, or similar mechanism that

provides a reduction in an individual's out-of-pocket expenses, associated with their health

insurance, shall permit such mechanism to be used by a person with or without health insurance

coverage for that prescription drug.

     (c) A person who manufactures a prescription drug who offers or makes available to an

insured in this state any discount, repayment, product voucher, or similar mechanism, shall

publish on the discount card, coupon, voucher, or similar material, and on any accompanying

advertisement and website, in an easily readable font and understandable format, a message that a

generic alternative has been approved by the United States Food and Drug Administration (FDA),

that the generic alternative may be available at a lower price, and instructions for the dispensing

pharmacist, to inform the consumer about all generic alternatives.

     (1) For the purpose of this section, a "generic alternative" means a drug designated to be

therapeutically equivalent, as indicated by the FDA's "Approved Drug Products with Therapeutic

Equivalence Evaluations." Subsection (c) of this section shall not apply to a branded prescription

drug until the time that the first drug designated in the FDA's "Approved Drug Products with

Therapeutic Equivalence Evaluations" as therapeutically equivalent to that branded prescription

drug has been nationally available, or, the active ingredients of the drug are contained in products

regulated by the FDA, are available without prescription at a lower cost, and are not otherwise

contraindicated for treatment of the condition for which the prescription drug is approved.

     (d) When calculating a patient's overall contribution to any out-of-pocket maximum,

deductible, co-payment, coinsurance, or other cost-sharing requirement, a health plan shall

include any amounts paid for by the patient or on behalf of the patient by another person. For the

purpose of this section, a "person" means a natural person, corporation, mutual company,

unincorporated association, partnership, joint venture, limited liability company, trust, estate,

foundation, not-for-profit corporation, unincorporated organization, government or governmental

subdivision or agency.

     SECTION 2. This act shall take effect on January 1, 2020.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- PRESCRIPTION DRUG BENEFITS--PRESCRIPTION

DRUG MARKETING

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     This act would regulate the marketing of prescription drug manufacturers using direct-to-

consumer marketing strategies including coupons, discount cards and similar offers to conceal the

true costs of high priced drugs, as opposed to lower cost alternatives, and by also making these

discounts available to individuals without health insurance.

     This act would take effect on January 1, 2020.

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