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06/14/2021 05:53 PM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20190&cosponId=31339
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House of Representatives
Session of 2019 - 2020 Regular Session

MEMORANDUM

Posted: March 3, 2020 03:59 PM
From: Representative Valerie S. Gaydos
To: All House members
Subject: Real Time Prescription Expense
 
In the near future, I plan to introduce legislation that would help patients and doctors get accurate, real-time information about out-of-pocket prescription costs as a way to help achieve better health outcomes.

The high cost of prescription drugs is a primary reason why patients abandon their prescriptions at the pharmacy, or do not adhere to the medication regimen. Patient nonadherence to prescribed medications is associated with poor clinical outcomes, and disease progression. It also results in an estimated $289 billion of avoidable health care costs in the US annually.

That is why I’m introducing the Patient Rx Information and Choice Expansion (PRICE) Act in PA. This legislation would require that all health plans and pharmacy benefit managers (PBMs) provide a real-time benefit tool (RTBT) to help prescribers and patients better understand their prescription costs. (This is already required on the Federal level with Medicare Part D).

Real-time benefit tools (RTBTs) are innovative technology solutions that provide patients and prescribers with accurate, real-time information about out-of-pocket prescription costs. RTBTs can empower providers and patients to make clinically appropriate and cost-effective medical decisions directly in the doctor’s office and which will reduce prescription abandonment, improve adherence and outcomes while also minimizing prescriber and dispenser burden. To be most effective in serving patients this legislation would require a RTBT be integrated with a prescribing or dispensing health care professional’s electronic health record (EHR) system for the transmission of real-time, patient-specific drug benefit and prescription price transparency information.

Please co-sponsor the PRICE Act and help bolster our efforts to improve healthcare outcomes in PA