The Alaska Legislature has endorsed pivotal legislation aimed at regulating and reforming Pharmacy Benefits Managers (PBMs) permitted to operate within the state. The bill is currently awaiting transmittal to Governor Dunleavy and his signature before becoming law. This important measure marks a critical step in addressing prescription drug affordability, pharmacy access, and reimbursement transparency, particularly benefiting rural Alaskans.
House Bill 226, passed during the 2024 legislative session, reins in unfair PBM trade practices that negatively impact Alaskan patients, employers and pharmacies. It also places a fiduciary duty of care on PBMs that will help align what is best for Alaskan employers with the PBM’s bottom-line. Presently, there are three massive PBMs in our state, each affiliated with/in ownership of a health insurance company, a mail order pharmacy, and prominent medical providers. This vertical integration allows PBMs to monopolize prescription drug processes in Alaska. This includes dictating pricing, coverage, cost containment measures, and determining where prescriptions can be filled, all at considerable expense to both Alaskan employers and patients. Many PBM practices are particularly harmful to Alaska Native/American Indian patients and Tribal Health Organizations. Prescription drug costs for employers and patients are skyrocketing while these PBMs are reporting tens of billions of dollars in profits annually.
The new legislation reduces opaque PBM business practices that drive prescription costs up and provides a lifeline to Alaska’s struggling private sector pharmacies. Particularly impactful in rural communities, where Tribal Healthcare Organizations (THOs) often serve as the sole healthcare option, this reform holds the promise of transformative benefits for Alaska Natives, American Indians, Veterans, and non-Natives alike.
Tanana Chiefs Conference extends its gratitude to legislators for the expeditious passage of House Bill 226, and to Tribal leaders statewide for their indispensable advocacy, ensuring that our collective voices resonated in this crucial legislative process.