SF1876

This bill, introduced in the Minnesota Senate (S.F. No. 1876) by Senator Mann, proposes new regulations for pharmacy benefit managers (PBMs) and health carriers regarding drug formularies. The bill mandates the inclusion of lower-cost drugs in formularies and requires formulary structures to prioritize drugs with the lowest out-of-pocket costs for patients.

Key provisions of the bill include:

1. Inclusion of Lower-Cost Drugs:

   • If a PBM or health carrier includes a brand-name drug in its formulary, it must also include the lowest-cost equivalent generic version.
     
   • If a lower-cost biosimilar is available, it must be included in the formulary alongside the brand-name biologic drug.
     
   • If a brand-name biologic has a lower wholesale acquisition cost than a biosimilar, it must also be included in the formulary.

2. Incorporation of Newly Approved Generic and Biosimilar Drugs:

   • Any newly FDA-approved generic or biosimilar drug that has a lower wholesale acquisition cost than current formulary drugs must be included immediately.

3. Formulary Structure and Tiering Requirements:

   • Formularies and tiering must be structured to prioritize the drug option with the lowest out-of-pocket cost for the patient.
     
   • PBMs and health carriers cannot impose prior authorization, step therapy, or other barriers that could limit patient access to the lowest-cost option.

This bill, if passed, would be codified under Minnesota Statutes Chapter 62W and aims to improve affordability and access to prescription drugs for Minnesota patients.