US 2006 Prescription Drug State Legislation Resources in United States

US 2006 Prescription Drug State Legislation Resources

State legislatures had a strong health policy focus on prescription drugs in 2006, enacting or adopting at least 85 laws and resolutions in 36 of the 43 states holding sessions.  During these 2006 legislative sessions, more than 600 bills were filed and considered, as detailed in this report.  Additionally, the governors of several states issued binding Executive Orders, especially to provide supplemental or emergency assistance for new Medicare Part D enrollees.

The following are examples of hot topics in 2006:

Medicare Part D/Emergency & Transition Fixes and Patches — 29 states considered 92 bills and resolutions intended to modify or adjust state pharmaceutical assistance efforts, in response to the federal Medicare Prescription Drug benefit launched in January 2006.  The most widespread actions focus on transitional “fixes” or “patches” for Medicare Part D to temporarily cover prescription drugs for dual-eligibles (people who qualify for both Medicare and Medicaid) and other Medicare enrollees.  At least 37 states and D.C. implemented emergency or transitional assistance to those who are legally entitled to benefits but are having trouble receiving them.

Discount and Subsidy Programs — A large number of states have already established subsidy and discount programs to reduce prescription drug costs and provide direct relief to low-income seniors.  In 2006, many states retooled their discount and subsidy programs to include Medicare Part D provisions.  New Mexico created a new discount prescription drug program open to residents of all ages to replace its existing senior-only drug program.  Oregon voters approved Ballot Measure 44 in November ’06, potentially creating the largest discount plan among the states.

Pharmacy Benefit Managers (PBMs) — Several states proposed legislation to regulate Pharmacy Benefit Management companies — the middlemen who negotiate directly with manufacturers.  The bills seek to assure financial reliability, regulate the licensing of pharmacy benefit managers and mandate full disclosure of financial contracts.  Two states have passed laws regulating PBMs, including Kansas and Mississippi, which enacted the “Pharmacy Benefit Prompt Payment Act” regulating repayments to local pharmacies.

Prescription Drug Reuse/Recycling — A number of states passed laws during 2006 that focus on the donation of unused pharmaceutical drugs.  States such as Florida and Nebraska established cancer drug repository programs that allow an individual, health care facility or drug manufacturer to donate cancer drugs or supplies needed to administer cancer drugs for use by those who meet eligibility criteria.  Other states, including Arkansas, Georgia, Louisiana, Maryland, Oklahoma and Tennessee, enacted laws creating general prescription drug donation programs.

Electronic Monitoring and Internet Prescribing — This is a relatively new trend, but one that gained momentum during the 2006 session.  At least 16 states proposed legislation or passed laws to allow for the development and regulation of electronic transmission of prescription drug orders, as well as establishing Internet prescribing practices to provide increased protection for consumers purchasing prescription drugs over the Internet.  Additionally, several states, including Iowa, Mississippi, South Carolina and Vermont, established electronic prescription drug databases to monitor the misuse, abuse and diversion of prescription drugs and controlled substances.

Marketing and Advertising — Several states already require pharmaceutical manufacturers to disclose marketing expenses, including gifts to drug prescribers.  During 2006, more than 20 states proposed legislation requiring marketing disclosures by drug manufacturers, regulating direct-to-consumer advertising of prescription drugs by pharmaceutical companies, and prohibiting prescription information from being sold for commercial purposes.

Other Topics of Interest — 13 states proposed legislation to create bulk prescription drug purchasing programs, with California, Oregon and South Carolina each passing a law to implement such a program.  Many states put forth bills that would have created prescription drug importation or re-importation programs, however none has been signed into law during 2006..  Bills that would provide income tax deductions, modifications, incentives or credits for pharmaceuticals or prescription drug-related programs were proposed in 7 states; Louisiana passed a law that exempts prescription drugs purchased through a Medicare Part D plan from all local sales and use taxes.  Cost containment also continues as a focus in some states, using measures to establish or modify preferred drug lists, and seek manufacturer rebates or discounts.  Other ideas, such as regulation of mail order prescription drug sales, oversight of pharmaceutical wholesalers, privacy of pharmacy records, publicizing clinical trials, and establishing bulk or multi-state purchasing programs have emerged as visible trends during 2006.

CSL’s separate 2005 Prescription Drug State Legislation online report includes all other bills filed in 2005, including more than 125 bills that became law in 44 states.  States with 2005 enacted laws are noted in Table 2 below, with a link to further information.

2006 Laws and Enacted Resolutions:  So far, laws have been passed and signed in 36 states: Alabama, Arizona, California, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington and Wisconsin.

Bills have passed both chambers in Rhode Island and West Virginia.  2006 finally enacted measures were vetoed in Coloradoand New York.

In addition, binding Executive Orders have been signed in Arizona, Minnesota, New Hampshire and Rhode Island.  Non-binding resolutions have been adopted in California, Idaho, Illinois and North Carolina.

This tracking report is designed to be updated regularly; future editions will include bills filed during the session year.  The report generally does not include legislation regulating only pharmacists and pharmacies, nor measures only affecting existing Medicaid plans.  Topic codes listed for individual bills identify major topics, but may not include all provisions.  Topic codes may include measures that would restrict, as well as expand, use of a particular policy.