HB 5556
Creating an external reference pricing pilot program for prescription drugs.
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- Passed House of Delegates
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill allows West Virginia’s Department of Human Services to create a pilot program to compare prescription drug prices to those paid in other industrialized nations. The program will focus on a limited number of high-cost drugs purchased through Medicaid and aims to potentially lower drug costs. The Department will evaluate the program’s effectiveness and make recommendations for its future based on cost savings, drug availability, and manufacturer participation.
Key provisions
- Establishes an external reference pricing pilot program for selected high-cost prescription drugs in the Medicaid program.
- Defines ‘external reference pricing’ as using prices paid in comparable countries.
- Limits the pilot program to a specific number of drugs and excludes those without international price comparisons.
- Requires the Department to preserve beneficiary access to necessary medications.
- Authorizes the Department to negotiate rebates with manufacturers.
- Allows for exceptions to reimbursement rates to prevent drug shortages.
- Mandates a three-year pilot period with annual reporting requirements.
- Excludes private insurers and existing pharmaceutical benefit contracts.
Who is affected
- West Virginia Medicaid recipients
- Pharmaceutical manufacturers
- Department of Human Services
- Joint Committee on Government and Finance
- The State of West Virginia
Notable changes
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