Malden legislators support passage of bill to lower prescription drug costs

Special to The Advocate

On December 30, 2024, State Senator Jason Lewis and State Representatives Paul Donato, Steve Ultrino and Kate Lipper-Garabedian joined their colleagues in the Massachusetts Legislature to enact comprehensive reforms to lower the cost of prescription drugs at the pharmacy counter and improve oversight of the state’s pharmaceutical industry. An Act relative to pharmaceutical access, costs and transparency takes bold action to lower or eliminate out-of-pocket costs and ensure access to life-saving medications by requiring health insurers to offer price relief for prescription drugs used to treat diabetes, asthma and certain heart conditions. This Act was passed by the Massachusetts Senate and House in 2023 and 2024, respectively, after which a committee of conference resolved their versions of the bill. On January 9, 2025, Governor Maura Healey signed it into law as Chapter 342 of the Acts of 2024.

Chapter 342 further brings down costs by ensuring that consumers are not charged a cost-sharing amount, such as a co-pay, if it would be cheaper for them to purchase the drug without using their insurance. Approximately 9% of Massachusetts residents have diagnosed diabetes; 6% of adults over 35 have heart disease; and more than 10% of residents live with asthma. Chapter 342 is particularly critical for residents of color, who disproportionately face chronic illnesses. Over 12% of Black residents live with diabetes and nearly 14% of Black adults live with asthma.

“Working to expand access to quality, affordable healthcare has always been one of my top priorities in the legislature,” said Senator Lewis. “I’m proud to support this critical legislation that makes life-saving drugs more affordable and accessible for patients, and holds pharmaceutical companies, insurers, and pharmacy benefit managers more accountable for their actions.”

“This legislation marks Massachusetts as a leader in addressing the rising costs of prescription medications,” said Representative Donato. “This bill emphasizes greater transparency in pricing and allows consumers to make informed decisions regarding their healthcare. It also shows the legislature’s continued commitment to reducing costs and improving the quality of healthcare in the Commonwealth.”

“With this legislation, we take a significant step forward in making healthcare more accessible to all. By passing this bill to lower prescription drug costs, we are ensuring that no one has to sacrifice their health due to unaffordable medications,“ said Representative Ultrino. “This is a win for all who have felt the strain of rising drug prices. We will continue to work to create a healthcare system that prioritizes the well-being of our communities.”

“Too often, patients are forced to pay exorbitant costs for prescription drug medications,” said Representative Lipper-Garabedian. “I was proud to join my colleagues to support this legislation to reduce copays, cover generic drug prescription costs, and ensure increased oversight and regulations of Pharmacy Benefit Managers. This bill furthers the Commonwealth’s commitment to ensuring healthcare is affordable, accessible, and equitable for all of our residents.”

Key provisions of this legislation:

• Lowering consumer prescription drug costs for diabetes, asthma and certain heart conditions by requiring insurers to eliminate cost-sharing requirements for one generic drug and to cap copayments on one brand-name drug at $25 per 30-day supply
• Increasing oversight of pharmacy benefit managers (PBMs) by authorizing the state Division of Insurance to license and regulate PBMs, who play a major role in determining how prescription drugs are tiered and priced on insurance plans
• Establishing the Office for Pharmaceutical Policy and Analysis within the Health Policy Commission (HPC) to analyze trends and publish an annual report with recommendations for strategies to promote affordability, enhance medication access and mitigate pharmaceutical spending growth
• Requiring pharmaceutical manufacturers and PBMs to provide public testimony on the factors that influence drug costs and allowing these factors to be taken into account by the HPC to identify how to improve care and reduce costs for patients