CHAPTER 126-BB NEW HAMPSHIRE PRESCRIPTION DRUG AFFORDABILITY BOARD
Section 126-BB:5
126-BB:5 Powers and Duties of the Board. –
The board has the following powers and duties:
I. (a) Beginning with the year 2022 and in consultation with the advisory council, the board shall identify strategies that optimize spending by public payors for pharmaceutical products while reasonably ensuring subscriber access to needed pharmaceutical products. To achieve this goal, the board shall determine annual spending targets for prescription drugs purchased by public payors based upon a 10-year rolling average of the medical care services component of the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index, medical care services index, plus a reasonable percentage for inflation and minus a spending target for pharmacy savings as determined by the board.
(b) The board shall determine spending targets on specific prescription drugs that may cause affordability challenges to enrollees in a public payor health plan. Such targets shall consider any medical cost offsets achieved by utilization of the drug.
(c) The board shall determine which public payors are likely to exceed the spending targets determined under subparagraph (a).
II. The board may consider the following data to accomplish its duties under this section:
(a) A public payor's prescription drug spending data, which the 3rd-party administrator or insurer for the public payor's health plan shall provide to the board on behalf of the public payor upon request notwithstanding any provision of law to the contrary, including:
(1) Expenditures and utilization data for prescription drugs for each plan offered by a public payor.
(2) The formulary for each plan offered by a public payor and prescription drugs common to each formulary.
(3) Pharmacy benefit management services and other administrative expenses of the prescription drug benefit for each plan offered by a public payor.
(4) Enrollee cost sharing for each plan offered by a public payor.
(5) Aggregate net spending on the prescription drug benefit.
(b) Data compiled by the department of health and human services. Prescription drug spending data provided to the board under this subparagraph is confidential to the same extent it is confidential while in the custody of the entity that provided the data to the board.
III. Based upon the prescription drug spending data received under paragraph II, the board, in consultation with a representative of each public payor shall determine methods for the public payor to meet the spending targets established under paragraph I. While continuing to ensure adequate access by subscribers to needed prescribed pharmaceutical products, the board shall determine whether the following methods reduce costs to individuals purchasing prescription drugs through a public payor and allow public payors to meet the spending targets established under paragraph I:
(a) Negotiating specific rebate amounts on the prescription drugs that contribute most to spending that exceeds the spending targets.
(b) Changing a formulary when sufficient rebates cannot be secured under subparagraph (a).
(c) Establishing a common prescription drug formulary for all public payors.
(d) Prohibiting health insurance carriers in the state administering benefits for a public payor from offering on their formularies prescription drugs when the method described in subparagraph (b) is implemented.
(e) Purchasing prescription drugs in bulk or through a single purchasing agreement for use among public payors.
(f) Collaborating with other states and state prescription drug purchasing consortia to purchase prescription drugs in bulk or to jointly negotiate rebates.
(g) Allowing health insurance carriers providing coverage to small businesses and individuals in the state to participate in the public payor prescription drug benefit for a fee.
(h) Procuring common expert services for public payor, including but not limited to pharmacy benefit management services and actuarial services.
IV. By November 1, 2020 and annually thereafter, the board shall report its recommendations, including prescription drug spending targets, their strategies for optimization of affordability of prescription drugs for the state and all of its residents, the progress of implementing those recommendations, as well as the annual net spending by public payors on prescription pharmaceutical products as a measure of the efficacy of implementation of those recommendations to date, to the standing committees of the general court with jurisdiction over health coverage and insurance matters and to the governor. This report shall also contain the following information about prescription drugs, both brand name and generic:
(a) The 25 most frequently prescribed drugs in the state;
(b) The 25 costliest drugs as determined by the total amount spent on those drugs in the state; and
(c) The 25 drugs with the highest year-over-year cost increases as determined by the total amount spent on those drugs in the state.
V. The board may apply for and receive funds, grants, or contracts from public and private sources.