STATEMENT FROM NCODA Legislative & Policy Advisory Committee
Contact: Kevin Scorsone | NCODA Legislative & Policy Liaison
Phone: (919) 903-2057


            NCODA was thrilled to announce the major legislative victory in the state of Texas that regulates Pharmacy Benefit Managers (PBMs). Last week, legislation in Tennessee was passed that would mirror the progress made in Texas. The Tennessee legislation will help reform PBM’s practices that have negatively impacted oncology patients and their access to cancer medications.

The Tennessee bill focuses on two major issues. First, the bill will allow patients to choose where they want to fill their prescriptions. Secondly, the legislation increases over site of PBM activities and business practices related to regulatory affairs, requires PBMS to report financial information, and increases transparency to their often, obscure financial methodologies. As a result of this legislation, patients will have a clearer understanding of their co-pay amounts and financial responsibility in a more concise and less opaque matter.

The recent trend at various state levels to regulate PBM’s is something that NCODA hopes will continue. We have witnessed the recent decision in Texas and we understand and support the positive impact that legislation like this can make in the lives of cancer patients. PBM’s have been able to operate with little to no regulation in many states for years. Unregulated PBM business practices have contributed to the financial toxicity cancer patients struggle with —- deciding whether to purchase their medicine or purchase groceries for their family. Unregulated PBM’s force patients to use specific mail order pharmacies most likely very distant from where patients actually live and have established personal relationships with neighborhood pharmacists.  Steerage to PBM owned specialty pharmacies results in treatment delays, a lack of appropriate oversight and medication management and increased waste and costs.  These are some terrible examples of what cancer patients and their families struggle with to access to life-saving medications and will hopefully become a distant memory in those states that have decided to regulate PBM’s.

NCODA applauds the decision by Tennessee lawmakers and acknowledges that this is another positive win in the legislative trend to regulate PBM’s. We hope that additional states continue to examine the issue and act to promote PBM legislation in the direction that favors patients.

NCODA will continue to provide updates and educate our membership as this and other issues arise in the world of oncology legislation.

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