MN HF1076

Pharmacy benefit managers and health carriers must include the lowest-cost generic drug or biosimilar in their formularies when they already cover the equivalent brand name drug, and vice versa if the brand name has a lower wholesale acquisition cost.

Newly FDA-approved generic drugs and biosimilars with lower wholesale acquisition costs than existing formulary options must be immediately added to formularies.

Formulary structures and tiering must give preference to whichever drug (brand or generic/biosimilar) has the lowest out-of-pocket cost to the patient.

Prior authorization, step therapy requirements, and other coverage limitations are prohibited for drugs with the lowest out-of-pocket cost to patients.

Effective date: January 1, 2026.