Prescription Drug Purchasing Consortium. In 2005, the Legislature directed Health Care Authority (HCA) to establish a prescription drug purchasing consortium. In addition to state agencies, the consortium may include, on a voluntary basis, local government, private entities, labor organizations, and individuals without insurance, or who are underinsured for prescription drug coverage. State purchased health care services purchased through health carriers and health maintenance organizations are exempted from participating in the consortium. In 2006, Washington and Oregon formed the Northwest Prescription Drug Consortium (Northwest Consortium) to expand their purchasing power. The Northwest Consortium offers access to retail pharmacy discounts, pharmacy benefit management services, rebate management services, and a prescription discount card for uninsured residents.
Prescription Drug Price Transparency Legislation. In 2019, the Legislature enacted legislation requiring health carriers, prescription drug manufacturers, pharmacy benefit managers (PBMs), and pharmacy service administration organizations (PSAOs) to report certain drug pricing information to HCA, which HCA would then use to publish an annual report.
HCA must compile the information collected from health carriers, PBMs, drug manufacturers, and PSAOs and prepare an annual report for the Legislature demonstrating the overall impact of drug costs on health care premiums. The data in the report must be aggregated and not reveal information specific to individual health carriers, PBMs, PSAOs, prescription drugs, classes of prescription drugs, or manufacturers. The data collected is not subject to public disclosure. Upon the request of a legislator, the HCA must provide all data submitted under the act and any analysis prepared by the HCA. Any information provided must be kept confidential within the Legislature and may not be publicly released
Identified drugs are drugs identified by the Institute for Clinical and Economic Review as having a price increase for which there is no, or inadequate, new clinical evidence to support the price increase. Within 60 days of publication of the institute's annual unsupported price increase report, HCA must notify the manufacturers of each identified drug.
HCA may assess a penalty against a manufacturer of an identified drug of 80 percent of the difference between the revenue generated by sales of the drug within the state and the revenue that would have been generated if the manufacturer had maintained the wholesale acquisition cost from the previous calendar year, if the manufacturer:
Any manufacturer notified by HCA, must submit the following information:
All revenue collected pursuant to the penalty must be deposited into the foundational public services account.
A manufacturer or distributor may not withdraw an identified drug from the market for the purpose of avoiding the penalty. The authority must assess a penalty of $500,000 per identified drug on any entity that it determines has withdrawn an identified drug from the state in violation of this act.