Prescription Drug Access In Rural Areas (HB 54)

by Bekah Jung

Imagine you are on anti-seizure medications and you run low. You only have two pills left and ordering online, although considerably cheaper, would take your pills five to ten days to get to your home. You have no option, but to pay a higher copay and get your pills because to not take your pills for a couple of days is too much of a risk. That particular situation happened to my roommate, who, like most college students, has difficulty choosing the more expensive route, even if it is a life or death decision. Now imagine a world where drugs online and drugs at your local pharmacy cost the same. You now have an option to either have your prescription drugs delivered to your door and filled by an out-of-state mail-order pharmacy or to support your local pharmacy and get your prescription filled there.

House Bill 54 “Prescription Drug Access in Rural Areas” sponsored by Representative Dixon M. Pitcher, will, as the National Legislative Association on Prescription Drug Prices says, “prohibit Pharmacy Benefit Managers (PBM) from charging higher copayments for prescription drugs if patients” choose to “buy locally rather than out-of-state mail-order pharmacy.” The bill will also require that PBMs be required to reimburse local pharmacists fairly for all prescription drugs they refill.

Not only are patients required to pay more copay for their prescriptions if they decide to buy locally, but local pharmacies are loosing money as well due to the lack of reimbursement from PBMs. As stated by Representative Dixon M. Pitcher in the Salt Lake Tribune, “[PBMs] control how much pharmacies get reimbursed for the prescription drugs they dispense… It can be a loosing proposition for both the patient and local pharmacists.” The patients lose because PBMs choose where to buy their prescription drugs by only covering drugs bought at certain big, online pharmacy companies. The local pharmacies are loosing because their costumers are buying online and when costumers do come in to buy prescription drugs, PBMs do not reimburse them fully, thus causing a loss in revenue.

For now, HB 54 will only apply to rural areas in Utah, but Pitcher is hopeful that it will soon become a statewide law. He also hopes that the bill will allow for better competition between big prescription filling companies and local pharmacies as well as lessen the influence of PBMs, which restricts and controls where patients should get their prescriptions and medications filled and where they should not. Because the PBMs rise to power has been gradual, HB 54 was mainly made to make an amendment to the Pharmacy Practice Act Rule, particularly to section R156-17b titled “Operating Standards for Third Party Payors” by stating that third party payers have to cover all prescription drugs the same amount no matter where the drugs are being bought.

Overall, HB 54, although presented by Pitcher as a pro-competition bill, allows for patients to choose where they get their prescription drugs. The bill also gives local pharmacists the chance to compete with bigger pharmaceutical companies and suppresses the power of PBMs. Prospects for the bill passing looks good. From a Democrat’s point of view, it is pushing for more insurance coverage so that insurance coverage is equal no matter where patients decide to get their prescription drugs. From a Republican’s point of view, HB 54 is pushing for boosting small businesses thus creating more competition in the pharmaceutical business world. From a patient’s point of view, HB 54 will allow for them to make a choice where to get their drugs, which could allow for more convenience on the patient’s part.