Gov. Tony Evers today was joined by State Representative Lisa Subeck (D-Madison) in Wausau today to introduce the "Less for Rx" prescription drug plan. This legislative package is comprised of bold initiatives proposed by Gov. Evers as part of his 2021-2023 biennial budget earlier this year and builds on the work of the Governor’s Task Force on Reducing Prescription Drug Prices with more than a dozen innovative and effective policy solutions to reduce the price of prescription drugs and ensure Wisconsinites can access and afford the medications they need.
“Everyone should be able to afford their medication but for far too many Wisconsinites their prescription medications remain out of reach with outrageous, irrational, and burdensome out-of-pocket expenses,” said Gov. Evers. “It's time for bold solutions and comprehensive reform that increases transparency and accountability, reduces out-of-pocket expenses, and tackles this issue head on.”
“Serving on the Governor's Task Force on Reducing Prescription Drug Prices, I heard from people across the state who struggle to pay for their medications,” said State Rep. Lisa Subeck (D-Madison). “All Wisconsinites need and deserve access to affordable healthcare, including prescription drugs, and this package today could provide some much-needed relief to patients struggling to afford potentially lifesaving medications they or their children need.”
“The Governor's Task Force on Reducing Prescription Drug Prices made recommendations that would control costs, increase transparency, and support our state's most vulnerable. I am glad to see those proposals continue to move forward in this legislative package so that every Wisconsinite can get the medications they need,” said Office of the Commissioner of Insurance Mark Afable.
“No one should have to ration their medications because they can't afford it,” said State Sen. Jon Erpenbach (D-West Point) and co-author of the package. “This package of bills is an important step to help ensure that Wisconsinites can afford the medications they need. Rather than allowing powerful drug companies and insurance executives to write their own rules, Democrats are fighting to expand healthcare coverage and lower prescription costs for everyone.”
Lowering Prices and Controlling Costs
- Creating a Prescription Drug Affordability Review Board to establish prescription drug spending targets for public sector entities and establishing price limits;
- Creating a Prescription Drug Importation Program that would allow the state to import drugs that would create substantial savings for Wisconsin consumers and taxpayers;
- Providing the state with the authority to study, develop, and pursue a State Prescription Drug Purchasing Entity allowing state and local collaboration to combine and leverage purchasing power to reduce the cost of prescription drugs and save taxpayer dollars;
- Improving the Wisconsin Drug Repository Program by streamlining processes and allowing partnerships;
- Ending discriminatory reimbursement practices toward 340B programs;
- Under certain circumstances, requiring insurers to apply discounts and coupons utilized by consumers to deductibles and annual out-of-pocket maximums; and
- Creating a Patient Pharmacy Benefit Tool to help prescribers take out-of-pocket costs into consideration when choosing between medically-similar medication options.
Increasing Transparency and Protecting Consumers
- Creating the Office of Prescription Drug Affordability to oversee and regulate the pharmaceutical supply chain and serve as a watchdog for Wisconsin consumers;
- Increasing consumer protections for Wisconsinites from attempts to artificially raise prices or mislead consumers through deceptive marketing and advertising practices; and
- Coupled with 2021 Wisconsin Act 9, this legislation will require transparency and reporting across the entire prescription drug supply chain, from manufacturers and pharmacy benefit managers (PBMs) to pharmacy services administration organizations (PSAOs) and health plans and provide oversight and requiring reporting or licensing for PBMs, PSAOs, PBM brokers and consultants, and Pharmaceutical Sales Representatives.
Ensuring Access for Wisconsin's Most Vulnerable
- Establishing a $50 copay cap on insulin to ensure insulin is affordable for all Wisconsinites;
- Creating an Insulin Safety Net Program to ensure folks never need to choose between rationing insulin and meeting other basic needs;
- Establishing an innovative pilot program aimed at developing a value-based formulary for diabetes medication;
- Increasing funding for free and charitable clinics by $4 million over the biennium;
- Encouraging pharmacists to volunteer at clinics providing no-cost care to Wisconsin's most vulnerable, strengthening the healthcare workforce to improve access; and
- Eliminating BadgerCare prescription drug copayments to make the prescription drug benefit more accessible.
The "Less for Rx" plan includes LRBs 2313, 3315, 3317, 3319, 3331, 3332, 3333, 3334, 3335, 3336, 3337, 3338, and 3339.
During the budget process, Republican legislators rejected the governor’s comprehensive plan to lower prices and declined to take meaningful action to help Wisconsinites afford the medicine they need. Gov. Evers earlier this year signed into law 2021 Wisconsin Act 9, which will increase transparency in the prescription drug supply chain by creating licensing and practice requirements for pharmacy benefit managers (PBMs) in the state of Wisconsin.