West Virginia took a big step towards making insurance work like it should last week. As of July 1, thanks to bipartisan state legislation passed and signed by the Governor in 2021, insurers and their pharmacy benefit managers (PBMs) are required to share the savings they negotiate on medicines directly with West Virginia patients. This makes the Mountain State the first in the nation to answer the question: If health insurance companies and middlemen don’t pay the full price for medicines, why are you?
Recent polling by Morning Consult shows that Americans want policymakers to see lowering out-of-pocket costs for health care as a top priority. In fact, 80% of West Virginians support requiring health insurance companies and PBMs to pass along the rebates and discounts they receive from manufacturers so that patients pay less for their prescription medicines at the pharmacy counter.
Seven months into the year, this new law could mean big savings for West Virginians who have not yet met their deductible. For those who have met their deductible, savings should be coming in January of 2023. Not a bad way to kick-off a new year.
No one should struggle to access or afford the medicines they need. Lower out-of-pocket costs can help to bring more predictability for patients, improve medication adherence and health equity, resulting in better health outcomes for West Virginians. That’s worth celebrating.
Want to learn more about the multiple ways to help patients better access and afford medicines in your state?
PhRMA recently launched the State Policies and Issues landing page at PhRMA/States. We hope that you’ll use this new resource to stay updated on the latest data and insights we have available, like more information about polling data and patient-focused solutions that states can enact to help patients pay less.
Reid Porter
Reid Porter is senior director of public affairs at PhRMA, where he focuses on key policy priorities, member engagement and state media relations. He brings over two decades of experience leading communications and managing complex issues across the biopharmaceutical, technology and energy sectors. Porter holds a B.A. from Middlebury College, where he double‑majored in English and Spanish, and a graduate certificate in Publishing from Columbia University. Outside of work, he enjoys writing, traveling, cheering for the Green Bay Packers, playing and watching soccer, playing the violin, rereading Hemingway novels and spending time with family.
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Patients win as West Virginia implements first-in-nation share the savings policy
Health Insurance
Out-of-Pocket Costs
PBMs/Insurance
Policy Solutions
Patients win as West Virginia implements first-in-nation share the savings policy
Patients win as West Virginia implements first-in-nation share the savings policy