AN ACT to amend Tennessee Code Annotated, Title 4; Title 53; Title 56; Title 68 and Title 71, relative to biosimilar medicine.
Impact
If passed, SB0436 would amend existing statutes to formally include biosimilars in health coverage regulations. The law will prohibit health carriers and benefit plans from requiring patients to first try a generic equivalent or interchangeable biological product before covering the appropriate branded drug. This change facilitates easier access to biosimilars and is expected to encourage their use, which could lower overall healthcare expenses related to diabetes, cancer, and other chronic conditions that rely on biologic therapies.
Summary
Senate Bill 0436 aims to enhance access to biosimilar medicines by modifying various sections of the Tennessee Code Annotated. The legislature recognizes that biosimilars, which are biological products approved by the FDA, may significantly reduce the costs of prescription drugs. This bill intends to eliminate barriers impeding access to these medicines, thereby promoting affordability and competition in the pharmaceutical market.
Sentiment
The sentiment surrounding SB0436 is largely positive as proponents emphasize the potential cost savings and increased access it offers to patients, particularly those with chronic health conditions requiring biologic treatments. Advocates believe that this legislation is a progressive step toward healthcare affordability. Conversely, there is a cautious perspective among some healthcare providers who express concerns regarding the safety and efficacy standards of biosimilars compared to their reference products.
Contention
Notable points of contention include the debate over the safety profiles of biosimilars and potential resistance from pharmaceutical companies that might argue against the changes. There is a concern that not adequately addressing the quality of biosimilar medicines could lead to discrepancies in patient care outcomes. Additionally, the legislative discussions have highlighted differing views on how insurance companies might react to these changes, specifically regarding their coverage policies and methods to evaluate new biosimilars.
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.
Pharmacy benefit managers and health carriers inclusion of lower-cost drugs in formularies requirement provision and lowest out-of-pocket-cost drug to patient formulary tiering preference provision