A recent legislative measure aimed at enhancing the transparency of pharmacy benefit managers (PBMs) in Mississippi garnered approval from the House of Representatives on Thursday.


However, both the Board of Pharmacy and numerous pharmacists express concerns that the proposed legislation falls short of providing substantial assistance to pharmacies and patients.


House Speaker Jason White, the bill’s sponsor, described it as “a good first step,” emphasizing that it would allow both the Board of Pharmacy and the public to access critical information about the practices of these companies, ensuring compliance with existing laws.


The bill saw overwhelming support, passing with a vote of 88-8, and includes several key provisions:


1. It prohibits PBMs from charging insurers more for medications than what pharmacies receive, a tactic that can be exploited to boost profit margins.


2. It mandates that PBMs file reports detailing the rebates and savings they obtain from drug manufacturers, as well as disclosing their affiliations with pharmacies to the Board of Pharmacy.


3. It requires drug manufacturers and health insurers to provide reports on wholesale drug pricing and overall spending on medications to the Board of Pharmacy.


4. The Board of Pharmacy will establish a website to summarize these reports for public access.


5. The Board is also empowered to issue subpoenas during audits of PBMs and will require noncompliant companies to cover the costs of those audits.


The legislation will now proceed to the Senate for further deliberation.


Yet, some advocates argue that the bill doesn’t do enough to defend independent pharmacists or retail pharmacies that are not part of publicly traded chains, along with the customers they serve.


Independent pharmacists in Mississippi are particularly concerned about potentially closing their businesses due to inadequate payments from PBMs, a situation exacerbated by their limited capacity to negotiate.


“Gathering the data is one aspect. Effectively using it is entirely different,” remarked Robert Dozier, who leads the Mississippi Independent Pharmacy Association. “When one analyzes the legislation, it offers little support for pharmacists and doesn’t tighten the loopholes that need addressing.”


During a House session, a statement delivered by Rep. Stacey Hobgood-Wilkes, the Republican chair of the Drug Policy Committee from Picayune, indicated that the Mississippi Board of Pharmacy sought amendments to increase its regulatory enforcement power over PBMs without specifying what additional tools would be beneficial.


The Board had not provided any comments in time for publication.


Dozier expressed his backing for an alternative bill proposed by Hobgood-Wilkes that aims to create a standardized pricing mechanism for prescriptions based on national average prices.


Such pricing models have successfully been implemented in several states, including Kentucky, to regulate medication costs.


Nonetheless, White expressed skepticism about the House’s readiness to endorse a standardized pricing model and indicated he would oppose the bill should it reach the floor.


In previous attempts, legislation aimed at regulating PBMs in Mississippi has struggled to gain traction. A proposed 2023 bill from Hobgood-Wilkes that utilized the pricing model ultimately failed in the House Insurance Committee, overseen by Rep. Jerry Turner.


Additionally, a 2024 bill intended to boost pricing transparency and prohibit PBMs from retaliating against pharmacies did not advance in the House.


White did express his willingness to support funding for additional personnel to enable the Board of Pharmacy to fulfill the new obligations outlined in the bill.