Specifications include, but are not limited to: The State intends to partner with an organization to undergo a study that shall analyze Pharmacy Benefits Managers (PBM) practices of prescription drug distribution. Deliverables include a report containing a study and recommendations. Per Public Act 23-117 Section 7, the study shall include, but is not limited to: • The data for PBM total spend, rebates, and profits in Connecticut. • How PBMs are utilizing spread pricing arrangements. • How PBMs are utilizing copay claw backs. • How PBMs are creating and utilizing profit-oriented formulary design. • How PBMs are utilizing manufacturing rebates, and transparency around those rebates. • An evaluation of prescription drug distribution practices conducted by PBMs in other states. The study should include what is known about the PBM landscape in Connecticut: • Which PBMs are in operation in Connecticut • Number of covered lives associated with each PBM • Corporate structure and relationships to insurers and other entities. • How PBMs are related to the various insurance markets – Medicare Advantage, state employees, self-insured, fully-insured, exchange etc. The recommendations shall include but are not limited to 1) reducing prescription drug costs for consumers in Connecticut, and 2) legislation to regulate pharmacy benefits managers in Connecticut. The study should provide an environmental scan of PBM oversight practices in other states, recommendations for how Connecticut may improve oversight of PBMs in our state, and whether or not any of the practices identified in the study may require further transparency or regulation.
