Bill would set price and pharmacy payment rules for certain drugs

Drug makers would be barred from accepting more than the federal maximum price for covered drugs sold for use in Minnesota. The rule would cover prescription drugs subject to a federal maximum fair price and intended for use by people in Minnesota, whether sold in person, by mail, or another way. The cap would allow applicable pharmacy dispensing fees and provider administration fees in addition to the maximum price. The 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 price or NADAC, plus any established dispensing fee. The rule would apply to pharmacies dispensing drugs subject to a federal maximum fair price. A pharmacy could receive a dispensing fee above the federal maximum price. The section would take effect January 1, 2027.

Health plans and pharmacy benefit managers would have to give the Prescription Drug Affordability Board payment and fee information upon request. The request could concern a covered drug dispensed by a pharmacy and would include related fees, adjustments, and reconciliations. The information would be subject to the data requirements in section 62J.91, subdivision 3. The section would take effect January 1, 2027.

Drug makers would be barred from withdrawing a covered drug to avoid the price limits unless they gave the health commissioner written notice within 180 days before withdrawal. The rule would cover a drug maker withdrawing a drug from sale or distribution in Minnesota for the purpose of avoiding the section's price limits. For each drug withdrawn in violation of the rule, the commissioner would have to assess a civil penalty equal to the greater of $100,000 or the drug's total annual savings, as determined by the board. The section would take effect January 1, 2027.