MA H1092

Health Policy Commission gains authority to require drug manufacturers to disclose pricing information, including 5-year wholesale acquisition cost history, R&D expenditures, and justifications for price changes for drugs referred by the Center for Health Information and Analysis

Drugs triggering review include those costing over $50,000 annually per patient, biosimilars launched at less than 15% below the reference biologic price, and the top 25 drugs with greatest impact on health care spending

Commission must issue determination within 60 days on whether drug pricing is unreasonable or excessive, and provide recommendations such as alternative purchasing plans, bulk purchasing programs, or cost-sharing changes

Manufacturers who fail to comply with disclosure requirements or provide false information face civil penalties up to $500,000

Pharmacy benefit managers must obtain state licensure to contract with health carriers, and carriers must conduct annual audits of their pharmacy benefit managers' pricing and rebate practices