WV HB5430

Requires the Insurance Commissioner to conduct an annual study of pharmacy dispensing costs in West Virginia, with reports due to legislative committees by December 1, 2026, and annually thereafter.

Prohibits the Public Employees Insurance Agency (PEIA) and Medicaid from contracting with pharmacy benefit managers (PBMs) that own or have affiliate pharmacies licensed in West Virginia.

Mandates that PEIA and Medicaid implement a pharmacy cost containment tool by July 1, 2026, to engage prescribing providers with information on lowest net cost pharmaceutical decisions and polypharmacy reductions.

Bars PBMs from charging health plans more than the national average drug acquisition cost for prescription drugs, and requires PBMs to charge state-administered health plans the same price they pay pharmacies.

Prohibits PBMs from using or owning group purchasing organizations to avoid regulatory requirements under this article.