North Carolina lawmakers are considering major health insurance changes. At the same time
they are also considering substantial changes to the prescription drug industry. A number of bills are currently moving forward in North Carolina with the intention
of overhauling components of the health insurance and pharmacy industries. Powerful companies are pushing hard in the hopes of securing regulations in their favor
The changes to the laws in the state would include those regulating Blue Cross
Blue Shield of North Carolina, the largest health insurance company in the state
Those have already made it through their first committee though the vote was divided
a separate bill governing pharmacy benefit managers also moved forward. Those are used by large insurers to negotiate drug prices
This is only the latest step in a battle between those groups and independent pharmacies across the state that has been continuing for years
Lawmakers have also been considering a measure that would accelerate the process of prior authorization used by insurers to decide whether medical care will be
covered. That measure has also made it through the House Health Committee House Bill 246
The bill that would regulate pharmacy benefit managers. PBS also intends to ban several tactics such as spread pricing which PBS use to even out
drug prices, which would otherwise vary from one pharmacy to the next. According to independent pharmacists PBS
which process around 80% of us prescriptions use anti competitive practices as pharmaceutical industry middlemen in order to drive up profits
The health insurance and pharmacy industry bills are aiming to keep prices controlled
Pharmacist Representative Wayne Sasser said that the largest of the PBS made over $14 billion in 2022
Pretty evident. Most of that money is not flowing through to the ratepayers said Sasser
according to health insurance companies, they use PBS to keep drug costs controlled and costs would rise if the bill passes
We negotiate discounts with drug manufacturers, we negotiate discounts with pharmacies, said Pharmaceutical Care Management Association
lobbyist Connor Rose. We're the only entity in the supply chain whose role it is to reduce drug prices
There remains a long road before these bills could become law and it remains unclear whether they will be able to pass each stage along
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