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MADISON — Gov. Tony Evers today announced his 2021-23 biennial budget proposal will include a number of critical provisions to lower prescription drug prices and control costs, increase transparency and protect consumers, and ensure access to life-saving medications for Wisconsin's most vulnerable individuals.
“No Wisconsinite should have to choose between paying their bills and affording their prescription medication,” said Gov. Evers. “Picking up your prescription shouldn't break the bank, but we know too many Wisconsinites continue to struggle to afford their medications. That's just not right. Healthcare—medications or otherwise—shouldn’t be a privilege afforded only to the healthy and wealthy, and that's why we are going to be tackling this issue head-on in our budget.”
Gov. Evers has led on the issue of lowering the cost prescription drugs. In 2019, the governor established the Governor's Task Force on Reducing Prescription Drug Prices, bringing together stakeholders to comprehensively address soaring prescription drug prices in Wisconsin. The governor’s budget proposal builds on the work of the Task Force on Reducing Prescription Drug Prices with several key initiatives to reduce prescription drug costs, increase transparency, and protect consumers, including:
Lowering Prices and Controlling Costs
- Creating a Prescription Drug Affordability Review Board to establish prescription drug spending targets for public sector entities and establishing price limits;
- Creating a Prescription Drug Importation Program that would allow the state to import drugs that would create substantial savings for Wisconsin consumers and taxpayers;
- Providing the state with the authority to study, develop, and pursue a State Prescription Drug Purchasing Entity allowing state and local collaboration to combine and leverage purchasing power to reduce the cost of prescription drugs and save taxpayer dollars;
- Improving the Wisconsin Drug Repository Program by streamlining processes and allowing partnerships;
- Ending discriminatory reimbursement practices toward 340B programs;
- Under certain circumstances, requiring insurers to apply discounts and coupons utilized by consumers to deductibles and annual out-of-pocket maximums; and
- Creating a Patient Pharmacy Benefit Tool to help prescribers take out-of-pocket costs into consideration when choosing between medically-similar medication options.
Increasing Transparency and Protecting Consumers
- Creating the Office of Prescription Drug Affordability to oversee and regulate the pharmaceutical supply chain and serve as a watchdog for Wisconsin consumers;
- Increasing consumer protections for Wisconsinites from attempts to artificially raise prices or mislead consumers through deceptive marketing and advertising practices;
- Requiring transparency and reporting across the prescription drug supply chain, from manufacturers and pharmacy benefit managers (PBMs) to pharmacy services administration organizations (PSAOs) and health plans; and
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Providing oversight and requiting reporting or licensing for PBMs, PSAOs, PBM brokers and consultants, and Pharmaceutical Sales Representatives.
Ensuring Access for Wisconsin's Most Vulnerable
- Establishing a $50 copay cap on insulin to ensure insulin is affordable for all Wisconsinites;
- Creating an Insulin Safety Net Program to ensure folks never need to choose between rationing insulin and meeting other basic needs;
- Establishing an innovative pilot program aimed at developing a value-based formulary for diabetes medication;
- Increasing funding for free and charitable clinics by $4 million over the biennium;
- Encouraging pharmacists to volunteer at clinics providing no-cost care to Wisconsin's most vulnerable, strengthening the healthcare workforce to improve access; and
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Eliminating BadgerCare prescription drug copayments to make the prescription drug benefit more accessible.
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