Pharmacy benefit managers

A bill by Kolste to regulate pharmacy benefit managers, or PBMs — which act as brokers between drug makers, insurers, pharmacies and patients — has considerable bipartisan support, with more than 100 co-sponsors.

The bill would require PBMs to report rebates from drug makers and ban them from telling pharmacists they can’t inform patients of lower cost options, among other stipulations.

“People are just looking for a way we can help consumers,” and the bill would help reduce drug costs for many people, Kolste said.

Sanfelippo said, however, that many employers rely on PBMs to keep employee pharmacy costs down. “Something has to happen, but we also have to recognize the important role, really, that PBMs play,” he said.

Direct primary care

Sanfelippo’s bill to encourage direct primary care — in which patients pay doctors monthly fees for routine visits and lab tests, outside of health insurance — would be another way to help consumers, he said.

The bill would make it clear the arrangements aren’t subject to state insurance regulations and don’t qualify as insurance under the federal Affordable Care Act, Sanfelippo has said.