AN ACT to amend Tennessee Code Annotated, Title 4; Title 53; Title 56; Title 68 and Title 71, relative to biosimilar medicine.
Impact
This legislation impacts several sections of the Tennessee Code, specifically addressing how health plans and carriers interact with biosimilar medicines. One notable amendment is to ensure that insurers cannot require patients to first try a branded medication before allowing coverage for a biosimilar. This change is anticipated to improve patient access to more affordable medication options and promote wider adoption of biosimilars throughout the healthcare system, ultimately aiming to reduce overall healthcare costs for citizens.
Summary
House Bill 1198 aims to amend existing Tennessee laws related to biosimilar medicines, facilitating increased access and affordability for patients. The bill recognizes the potential for biosimilars, which are biological products approved by the FDA, to significantly lower prescription drug costs by incentivizing their use over branded medications. By clarifying and updating the definitions and regulations surrounding biosimilars, the bill seeks to remove existing barriers that prevent healthcare providers and patients from effectively utilizing these cost-saving alternatives.
Sentiment
The sentiment surrounding the passage of HB 1198 appears to be largely supportive, especially among healthcare advocates who herald the potential savings and improved access to critical medications. Legislators who support the bill view it as a necessary step towards modernizing healthcare regulations to align with advances in pharmaceutical science. However, there are concerns from some stakeholders about how such changes might affect the standardization of care and market dynamics, particularly regarding the pharmaceutical industry's response to increased biosimilar use.
Contention
While the bill promotes significant benefits, some contention exists regarding the implications for pharmaceutical innovation and the marketing strategies of brand-name drug manufacturers. Critics argue that the focus on biosimilars may lead to decreased investment in original drug development as companies may feel pressured by the increasing competition from cheaper alternatives. Additionally, there are worries about ensuring the quality and efficacy of biosimilars as more of them enter the market, which may lead to debates about patient safety and provider education on new drug options.
AN ACT to amend Tennessee Code Annotated, Title 4; Title 8; Title 33; Title 39; Title 49; Title 53; Title 56; Title 63; Title 68 and Title 71, relative to mental health.
To Mandate The Use Of Biosimilar Medicines Under Health Benefit Plans; To Require A Healthcare Provider To Prescribe Biosimilar Medicines; And To Improve Access To Biosimilar Medicines.
Requires health plan coverage to include generic drugs and biosimilars where the wholesale acquisition cost of such generic drugs or biosimilars is lower than the brand drug's wholesale acquisition cost.
Pharmacy benefit managers and health carriers required to include lower-cost drugs in their formularies, and formulary structure and formulary tiering for each health plan required to give preference to the drug with the lowest out-of-pocket cost to the patient.