Prescription drug price transparency

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).

Implementation

Drug manufacturers, health carriers, pharmacy benefit managers (PBMs), and pharmacy services administrative organizations (PSAOs) are not expected to submit data in 2019. There will not be imposed fines for not submitting in 2019. HCA anticipates being ready to collect data by October 2020.

After completing the bulk of the planning, HCA began notifying data submitters via a series of electronic notifications outlined below.

PBMs are not included in all initial communications as their reporting start date is later.

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

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

Carriers

• Data submission guide (updated 10/2/2020)
• Premium impact template
• Cost utilization template
• Specialty drug list template

Manufacturers

• Data submission guide (updated 9/15/2020)
• Covered drugs template
• New drugs template

Pharmacy Benefit Managers (PBMs)

• DRAFT data submission guide (posted 10/14/2020)

Pharmacy Services Administrative Organizations (PSAOs)

• Data submission guide (updated 9/16/2020)
• Pharmacy benefit manager contracted rates template
• Pharmacy contracted rates template
• Year-over-year rate change template

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