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Prescription drug price transparency

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Program updates

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

The table below highlights major milestone communications sent to reporting entities. It is not a comprehensive list of communications sent.

Date

Notification topic and audience

11/10/2021

Critical update to carrier and PSAO data submission guides

11/2/2021

Notification to PBMs: draft data submission guide posted

11/1/2021

Notification to carriers and PSAOs: DPT data submissions guides / templates finalized and posted

9/1/2021

Notification to carriers and PSAOs: DPT data submission guide updated and posted

6/16/2021

Notification to reporting entities of July listening sessions.

6/11/2021

Reminder to PBMs of submission due date.

5/14/2021

Notification to PBMs: DPT data submission guide and templates updated.

5/6/2021

Notification to PBMs: DPT data submission guide and templates finalized. Submissions due 6/30/2021.

3/25/2021

Notification to PBMs: DPT data submission guide and templates updated and posted

3/22/2021

Notification to manufacturers: submission guide finalized

3/22/2021

Critical update: notification to all submitter types of change to support email inboxes

2/19/2021

Notification to PBMs: submission deadline postponed

1/11/2021

Notification to PBMs: submission guide ready

1/7/2021

Notification to manufacturers: submission guide finalized

12/22/2020

Notification to carriers: submission guide finalized

12/1/2020

Notification to manufacturers: submission guide updated

11/20/2020

Notification to reporting entities: carrier and PSAO submission guides updated

11/9/2020

Notification to PBMs: reminder reminder of reporting requirement and draft PBM submission guide

10/28/2020 Drug Price Transparency data submission FAQ sent to all reporting entities
10/14/2020

Seventh letter to PBMs: draft PBM submission guide ready for review and feedback; reminder to register

9/15/2020

Sixth letter to reporting entities: data submission guides ready for manufacturers, carriers, and PSAOs; reminder to register

8/20/2020

Fifth letter to manufacturers: notification of data submission guide ready and a reminder to register

7/29/2020

Fourth letter to reporting entities: notification of data submission guide ready and a reminder to register

7/1/2020

Third letter to reporting entities: draft data submission guide and reminder to register

5/21/2020

Reminder letter to reporting entities: data definitions review and reminder to register

5/12/2020

Second letter to reporting entities: data definitions review and reminder to register

5/5/2020

Introductory letter to reporting entities: registration instructions

Reporting entity resources (carriers, manufacturers, PBMs, PSAOs)

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.

Important note about Excel version: We recommend using Microsoft Excel 2016 or earlier for the submission guides. Using Microsoft Excel 2019 can cause formatting issues when saving as a CSV file.

All

Carriers

Report year 2020 (due date: December 1, 2021)

Report years 2018 - 2019

Manufacturers

Report years 2019 - 2021

Pharmacy Benefit Managers (PBMs)

Report year 2020 (due date: March 1, 2022)

Pharmacy Services Administrative Organizations (PSAOs)

Report year 2020 (due date: December 1, 2021)

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

Date and time Meeting type Materials
July 28, 2021 PBM listening session

Slide deck

Listening session audio

July 22, 2021 Manufacturer listening session

Slide deck

Listening session audio

July 6, 2021 Carrier listening session

Slide deck

Listening session audio

April 29, 2020

Pharmacy benefit manager / pharmacy service administrative organization reporting

Webinar only, no in person meeting due to COVID-19

Slide deck

Recorded webinar

April 1, 2020

Issuer / carrier reporting

Webinar only, no in person meeting due to COVID-19

Updated slide deck

Recorded webinar

February 26, 2020 Manufacturer reporting

Slide deck

Recorded webinar

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).

Reports

Status report (posted January 1, 2021)
Created by HCA to detail the current state of the program as the agency begins to receive drug pricing and cost data.

Contact

Program questions and information
Email: HCA Drug Price Transparency - general inquiry

Technical data related questions, or any questions regarding the data submission process
Email: HCA Drug Price Transparency - tech support

Protections for insurance consumers and insurance industry oversight
Contact: Washington State Office of the Insurance Commissioner (OIC)