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:

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

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is hereby amended by adding thereto the following section:

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

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

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

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

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

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

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

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

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

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

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

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section addresses those cost concerns.

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

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

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

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

 

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coverage for that prescription drug.

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

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

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

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

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

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

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pharmacist, to inform the consumer about all generic alternatives.

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

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

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

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

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Therapeutic Equivalence Evaluations" as therapeutically equivalent to that branded prescription

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

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

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

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

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

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

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

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

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

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subdivision or agency.

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     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-

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

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

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discounts available to individuals without health insurance.

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     This act would take effect on January 1, 2020.

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