On Feb. 14, NM LEG passed bill to increase price transparency in drugs
NM LEG passed HB 33 Prescription Drug Price Transparency Act requiring prescription drug manufacturers, pharmacy services, insurers to report price trends to NM INS.
Prescription Drug Report
New sections of NM Insurance Code to provide relevant definitions and requires annual data submission to NM INS of drugs with wholesale price of $400 for 30-day supply.
Report due May 1, 2025, annually thereafter, in a form prescribed by superintendent.
Such drugs must be a brand name drug whose price has increased by 10% or more or a brand name drug whose wholesale cost has increased by 16% or more over 2 years.
Mandatory reporting also includes a generic drug or biosimilar product that has increased in wholesale acquisition price by 30% or more in the previous calendar year.
For each such drug report must include, e.g., introductory wholesale price at time of approval, annual increase over previous 5 years, direct costs of drug, total revenue.
When a new brand name drug has a price higher than Medicare specialty tier threshold manufacturer must report name of the drug to NM INS within 3 days of introduction.
When a new generic or biosimilar has a price higher than Medicare specialty tier threshold and not at least 15% lower than brand name, must report within 3 days.
Must also report any drug that is increasing to the Medicare specialty tier, must also report to NM INS by the date of the price increase with data on price change.
Data in the annual prescription drug manufacturers’ reports shall be kept confidential.
Pharmacy Services and Authorized Insurer Reports
By May 1, 2025, and annually thereafter, each pharmacy services administrative organization and authorized health insurer must report on products to NM INS.
Must include the 25 most frequently dispensed products, 25 most costly products by total annual spending, 25 products with the highest increase in total annual spending.
Insurer must also report on the evaluation of the effect that the cost of prescription drugs products has on health care premiums; data in reports will be kept confidential.
Pharmacy Benefit Reports
By May 1, 2025, and annually thereafter, each pharmacy benefits manager (PBM) report must include aggregate rebates and fees collected from manufacturers.
Aggregated dollar amount of rebates and fees that were passed on to authorized health insurers and consumers at the point of sale, or retained by the manager.
Reports may not disclose identities of insurers or consumers, the price charged for a specific product/class/products or amount of any rebate or fee for specific products.
NM INS Annual Report
By Dec. 2025, and annually thereafter, NM INS must report to legislature on pricing data including pricing trending, and populations most affected by high prices.
Additionally, must include recommendations for further action or needed legislation.
Enforcement
Parties subject to this statute may be subject to a penalty for failing to timely submit data or providing inaccurate or incomplete information or data in a report.
NM INS may audit parties subject to this statute in an approved form and manner.
Legislative History
On Jan. 1, 2024, bill was introduced in House; on Feb. 7, 2024, bill passed House.
On Feb. 8, 2024, bill was introduced in Senate; on Feb. 14, 2024, bill passed Senate.
Effectiveness
Upon approval by the governor, HB 33 provisions shall be effective on Jan. 1, 2025.
Mar. 2024 NM LEG Governor Approval
On Mar. 1, 2024, NM LEG reported HB 33 signed by governor, designated as Chap 33.
