Republican Lawmakers Try Again With New Rx Guideline, Compounding Pharmacy Bill

Tuesday, June 5, 2018 | 0

Five weeks after Pennsylvania Gov. Tom Wolf vetoed a hotly debated bill that would have set up a drug formulary and imposed more utilization reviews, Republican lawmakers are trying again.

Sen. Don White

Senate Bill 1187 was introduced last week by state Sen. Don White, R-Murraysville, and has been sent to the Senate Labor and Industry Committee. It is similar to SB 936, which White also sponsored, and which Wolf vetoed in April. 

Instead of a formulary, the new bill would require the Department of Labor to develop prescription guidelines. It also would address the controversial issue of compounded medications by stipulating that reimbursement for compounded drugs be limited to 110% of the average wholesale price of each ingredient.

Insurers and employers have long complained about the cost of compounded pharmaceuticals because some pharmacies have charged the maximum for each ingredient, which in some cases has resulted in bills for thousands of dollars for a single tube of ointment.

In announcing his veto of SB 936 in April, Wolf announced executive action that he said would address most of business interests' concerns over compounded drugs and prescribing guidelines. But White said the governor's actions don't go far enough, and statutory requirements are needed.

SB 1187 also would require more scrutiny of medical treatment by accredited, nationally recognized utilization review organizations, which critics have said is a back-door way to give insurance companies undue influence over medical decisions. 

The bill, though less intrusive than SB 936, "strips workers' compensation claimants of significant rights without conferring anything upon them in return that creates more effective or rapid access to treatments," said Irwin Aronson, attorney for the AFL-CIO in Pennsylvania.

The Pennsylvania legislative session ends June 30.