H.353 AN ACT RELATING TO PHARMACY BENEFIT MANAGEMENT - LYONS AMENDMENT

PASSED
in the State Senate
on May 9, 2022, by a vote of
24-4

Purpose: The underlying bill attempts to “safeguard against the loss of more independent and community pharmacies” while making prescription drugs “more affordable and accessible to Vermonters.”

3 out of 4 people in Vermont have the prescription drug coverage managed by 1 of 3 national pharmacy benefit manager companies (PBM’s): CVS, Express Scripts or Optum. PBM’s negotiate with private health insurance companies, giving them the option to choose a certain brand of medication with high profit margins and then forcing pharmacists who dispense the medication to never tell the customer if there is a cheaper alternative. H.353 would prohibit such contractual arrangements and would give Vermont’s Department of Financial Regulation access to some PBM financial information, in an effort to ensure medication prices are fair.

The Lyons Amendment would prohibit private health insurers from choosing cheaper mail-order pharmacies to fulfill specialty high-cost drug prescriptions, allowing only commercial specialty hospital pharmacies to fulfill these orders.

Analysis: Those voting YES believe giving Vermont’s government more oversight of the prescription drug market will restrict the ways in which pharmacies can charge more for their drugs. They believe money that would have gone to large, national PBM’s (like CVS) will go to local pharmacies instead. Some voting YES were in favor of the Lyons Amendment, suggesting that UVM’s mail-order pharmacy is the only one responsible enough to ship specialty drugs by mail.

Those voting NO worried about the Lyons Amendment, rather than the underlying bill. Forcing private insurers to purchase drugs at UVM’s Burlington pharmacy, the only commercial specialty pharmacy in Vermont. This could will push up drug prices for insurers, who will raise their health insurances rates, erasing any gains from the other parts of the bill.

As Recorded in the Senate Journal, Monday, May 9, 2022: “Thereupon, the bill was read the second time by title only pursuant to Rule 43, the proposal of amendment was agreed to, and third reading of the bill was ordered on a roll call, Yeas 24, Nays 4” (Read the Journal, p. 1293 – 1307).

View the floor debate on YouTube.

How They Voted

Becca Balint (D-Windham) – YES
Philip Baruth (D-Chittenden) – YES
Joe Benning (R-Caledonia) – ABSENT
Christopher Bray (D-Addison) – YES
Randy Brock (R-Franklin) – YES
Brian Campion (D-Bennington) – YES
Thomas Chittenden (D-Chittenden) – YES
Alison Clarkson (D-Windsor) – YES
Brian Collamore (R-Rutland) – YES
Ann Cummings (D-Washington) – NO
Ruth Hardy (D-Addison) – YES
Cheryl Hooker (D-Rutland) – YES
Russ Ingalls (R-Essex-Orleans) – YES
M. Jane Kitchel (D-Caledonia) – ABSENT
Virginia Lyons (D-Chittenden) – YES
Mark MacDonald (D-Orange) – YES
Richard Mazza (D-Chittenden-Grand Isle) – YES
Richard McCormack (D-Windsor) – YES
Alice Nitka (D-Windsor District) – YES
Corey Parent (R-Franklin) – NO
Chris Pearson (P-Chittenden) – YES
Andrew Perchlik (D-Washington) – NO
Anthony Pollina (P/D-Washington) – YES
Kesha Ram (D-Chittenden) – YES
Richard Sears (D-Bennington) – YES
Michael Sirotkin (D-Chittenden) – YES
Robert Starr (D-Essex-Orleans) – YES
Joshua Terenzini (R-Rutland) – YES
Richard Westman (R-Lamoille) – NO
Jeanette White (D-Windham) – YES

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