Bill would cap prices and set pharmacy payment rules for certain drugs

Manufacturers would be barred from accepting more than the federal maximum fair price for a covered drug sold for use in Minnesota. This covers prescription drugs with a federal maximum fair price that are intended for use by people in Minnesota, whether sold in person, by mail, or another way. Applicable pharmacy dispensing fees and provider administration fees may be added. This section would take effect January 1, 2027.

Health plans and pharmacy benefit managers would have to reimburse pharmacies at least the greater of the federal maximum fair price or the national average drug acquisition cost, plus an established dispensing fee. This applies when a health plan or a pharmacy benefit manager licensed under Minnesota law reimburses a pharmacy for a covered drug. A pharmacy may receive a dispensing fee above the federal maximum fair price. This section would take effect January 1, 2027.

Health plans and pharmacy benefit managers would have to provide payment and fee information to the Prescription Drug Affordability Board upon request. The information concerns payments made or owed to pharmacies for dispensing covered drugs, including ingredient costs and dispensing fees. The information must include related fees, adjustments, and reconciliations and follow the cited data requirements. This section would take effect January 1, 2027.

A manufacturer withdrawing a covered drug to avoid the price limits would have to give the health commissioner written notice within the 180 days before withdrawal. This applies to manufacturers withdrawing a covered drug from sale or distribution in Minnesota for the purpose of avoiding the section's price limits. For each drug withdrawn in violation, the commissioner would assess a civil penalty equal to the greater of $100,000 or the drug's annual savings as determined by the Prescription Drug Affordability Board. This section would take effect January 1, 2027; notice must be given within the 180 days before withdrawal.