Bill > SB01011

This bill aims to regulate pharmacy benefits managers (PBMs) by introducing two key requirements: First, the bill mandates that an enrollee's cost-sharing for prescription drugs must be calculated at the point of sale using the net price of the drug, which means the final price after rebates and discounts are applied, potentially lowering out-of-pocket costs for patients. Second, the bill requires each PBM operating in the state to certify to the Insurance Department that they have complied with the first requirement, creating an accountability mechanism. PBMs are intermediaries that negotiate drug prices between pharmaceutical manufacturers, health insurers, and pharmacies, and have been criticized for complex pricing practices that can make prescription drugs more expensive. By requiring calculation based on net price and mandating certification, this bill seeks to increase transparency and potentially reduce prescription drug costs for consumers by ensuring that any negotiated rebates or discounts are immediately reflected in the price patients pay at the pharmacy counter.

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https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=SB01011&which_year=2025