Prescription drug price transparency

Program updates

January 1, 2021 update

The Health Care Authority (HCA) has created a status report detailing the current state of the program as the agency begins to receive drug pricing and cost data from health carriers, pharmacy benefit managers (PBM), drug manufacturers and pharmacy service administrative organizations (PSAO).

October 15, 2020 update

HCA plans second phase rulemaking under RCW 43.71C

HCA is dedicated to working with reporting entities to ensure successful implementation of a Drug Price Transparency reporting program under RCW 43.71C. We are grateful for all input received thus far and remain committed to collaboration with our stakeholders. 

Accordingly, HCA will be launching a second phase of rulemaking with an anticipated CR-101 filing next week. The rulemaking will:

• Amend WAC 182-51-0600(2)(b) to clarify that manufacturers must report new covered drugs within 30 days after  release to the market instead of prior  to their release. In the meantime, HCA will not initiate enforcement under RCW 43.71C.090 for manufacturers who do not report the information required by RCW 43.71C.050 prior to the release of a new covered drug to the market. 
• Amend or create a new rule containing the contents of the nondisclosure agreement.

Reporting entity notifications

Reporting entity resources

The following resources are for reporting entities who may need assistance.

The excel templates below are available as an aid if you are hand-keying data for submissions to the Drug Price Transparency program. These workbooks are programmed with simple rules that will help you avoid some common errors that can occur.

All

• Reporting entity registration form
• Reporting entity extension request form
• Data submission FAQ (updated 11/9/2020)

Carriers

• Data submission guide (effective 12/22/2020)
• Premium impact template (effective 11/17/2020)
• Cost utilization template (effective 1/12/2021)
• Specialty drug list template (effective 11/17/2020)

Manufacturers

• Data submission guide (effective 1/7/2021)
• Covered drugs template (effective 12/1/2020)
• New drugs template (effective 12/1/2020)

Pharmacy Benefit Managers (PBMs)

• Data submission guide (effective 1/11/2021)
• Appeals template (effective 1/11/2021)
• Drug benefit plan template (effective 1/11/2021)
• Health plan template (effective 1/11/2021)
• Manufacturers template (effective 1/11/2021)
• Ownership template (effective 1/11/2021)
• Pharmacies template (effective 1/11/2021)

Pharmacy Services Administrative Organizations (PSAOs)

• Data submission guide (effective 11/17/2020)
• Pharmacy benefit manager contracted rates template (effective 11/17/2020)
• Pharmacy contracted rates template (effective 11/17/2020)
• Pharmacy benefit manager year-over-year rate change template (effective 11/17/2020)
• Pharmacy year-over-year rate change template (effective 11/17/2020)

Stakeholder meetings

At each meeting, HCA will give a short overview of Chapter 43.71C RCW then use the majority of time to take questions and hear concerns from stakeholders. We will focus on a different supplier in each meeting. The public is invited to participate in any of the meetings.

Meeting schedule

Background

In 2019, the Washington State Legislature passed Engrossed Second Substitute House Bill into law. This law states requires issuers of health insurance, pharmacy benefit managers (PBMs), manufacturers, and pharmacy service administrative organizations (PSAOs) to submit data to the Health Care Authority (HCA). The purpose is to create an annual report on how prescription drugs affect health care costs. The law also requires pharmaceutical manufacturers to submit data to HCA relating the new drug applications (NDA).