Senate Committee Passes Bipartisan HB 1094 to Help Reduce Healthcare Costs, Increase PBM Accountability

Bill Ensures PBMs are Working to Lower Prescription Drug Costs

DENVER – Yesterday evening, Colorado’s Senate Health and Human Services Committee passed bipartisan House Bill 1094 on a 7 to 2 vote to help reduce the costs of prescription drugs for Coloradans by holding pharmacy benefit managers (PBMs) accountable.

In their role as middlemen in the prescription drug system, PBMs are meant to negotiate lower prescription medication costs on behalf of health insurers, large employers, and ultimately Colorado patients. However, PBMs are in fact taking advantage of the prescription drug system and increasing out-of-pocket costs in order to secure larger profits. House Bill 1094 would prevent PBMs from generating revenue through high prescription prices, prevent them from restricting patient access to more affordable treatments, and ensure they pass on savings to patients as intended.

“The cost of prescription medications continues to be a significant financial burden for many Coloradans, and our constituents are looking to us to find solutions to this problem,” said Senator Dylan Roberts. “We need to take steps to increase transparency and accountability in our health care system, which means taking a close look at each link in our prescription drug supply chain, including PBMs. By ensuring that PBMs are actually working to lower prices for consumers, this bill takes a significant step toward a more affordable and accessible health care system for Colorado families.”

“This common-sense legislation restores PBMs to their original purpose of negotiating lower medication costs and returning the value they capture to their customers and patients,” said Senator Byron Pelton. “This bill will reduce medication costs for plan sponsors and patients while still allowing PBMs to make money when they use their negotiating power to hold pharmaceutical manufacturers accountable. The bill also guarantees pharmacies are reimbursed fairly to ensure they can keep serving their communities.”

Recent polling shows that 70% of Colorado residents experienced at least one healthcare affordability crisis in the past year, 83% worried about affording healthcare in the future, and 68% of all respondents had delayed or went without healthcare due to cost.

“Coloradans who live with chronic medical conditions are fighting day in and day out to lead healthy, happy lives, but too often, the high costs of prescription medications stand in their way,” said Sara Froelich, Executive Director of the Chronic Care Collaborative. “This legislation is critical to increase transparency and accountability in our health care system and reduce out-of-pocket costs for patients. We are encouraged to see lawmakers come together to advance this important bill and prioritize the health and wellness of our communities.”

Learn more about PBMs and meaningful policy reforms to lower costs at pbmaccountabilityco.org.