New Hampshire 2026 Regular Session

New Hampshire Senate Bill SB478

Introduced
11/21/25  
Refer
11/21/25  

Caption

Relative to strengthening prescription drug affordability and pharmacy benefits manager accountability.

Impact

The bill is designed to protect consumers and ensure that they have better access to affordable prescription medications. By prioritizing the lowest net-cost drugs and mandating timely access to pricing lists, SB478 seeks to reduce out-of-pocket expenses for patients. It reinforces the need for pharmacy benefit managers to act in the best interest of enrollees, thereby aligning incentives across various stakeholders in the healthcare system. The introduction of provisions on access to biosimilars and out-of-pocket smoothing further demonstrates the bill’s robust approach to addressing affordability.

Summary

Senate Bill 478 aims to improve prescription drug affordability and enhance accountability among pharmacy benefit managers (PBMs) in New Hampshire. The bill introduces significant regulatory measures that focus on increasing transparency around drug pricing, eliminating spread pricing practices, and ensuring that all rebates from manufacturers contribute to lowering drug costs for consumers. Additionally, it establishes strict auditing requirements and prohibits retroactive fees on clean claims, promoting fair practices within the pharmaceutical distribution sector.

Sentiment

General sentiment towards SB478 appears to be supportive among health advocates and consumer protection groups, who argue that it will significantly enhance the affordability and accessibility of medications. However, some stakeholders, particularly those in the pharmaceutical and insurance industries, have expressed concerns about the potential economic implications. The fear is that the bill may disrupt established pricing structures and operational practices, possibly leading to unintended consequences in the broader healthcare market.

Contention

Notable points of contention include the provision to cap out-of-pocket costs for insulin and the elimination of spread pricing, which some argue may affect PBMs' operational revenues negatively. The legality of the proposed awareness and reporting requirements, designed to secure transparency for consumers without revealing sensitive competitive data, also raised discussions. These debates highlight the ongoing tension between ensuring consumer protection and maintaining the financial viability of pharmacy benefit managers.

Companion Bills

No companion bills found.

Previously Filed As

NH HB645

Relative to data collection and reporting requirements of the prescription drug affordability board.

NH SB256

Relative to the affordability and safety of clinician administered drugs.

NH HB570

Repealing the prescription drug affordability board.

NH HB732

To enhance informed consent and accountability in psychotropic drug prescriptions for children under Medicaid.

NH SB247

Prohibiting network exclusion for pharmacies that refuse to dispense a prescription of the PBM reimbursement that is below the pharmacy's acquisition cost.

NH SB250

Relative to pharmacist administration of long-acting injectable drugs.

NH HB126

Relative to prescriptions for certain controlled drugs.

NH HB661

Relative to the department of health and human services management of social security payments, supplemental security income payments, and veterans benefits for children in foster care.

NH SB61

Relative to prescriptions for state prisoners paid for by the department of corrections.

NH SB119

Relative to Medicaid pharmaceutical services and relative to standing orders for Ivermectin.

Similar Bills

KS HB2551

Enacting the Kansas pharmacy services administrative organization act.

AR SB593

To Amend The Arkansas Pharmacy Benefits Manager Licensure Act; And To Create The Pharmacy Services Administrative Organization Act.

MS HB558

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

MS HB1125

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

NJ S2345

"Patient and Provider Protection Act."

AR SB475

To Establish The Pharmacy Services Administrative Organization Act; And To Regulate Pharmacy Services Administrative Organizations.

AZ HB2429

Pharmacy benefits; pharmacy management networks

AZ HB2813

pharmacy benefits; workers' compensation