September 10, 2021 - Introduced by Representatives Subeck, Hesselbein,
Anderson, Cabral-Guevara, Cabrera, Conley, Considine, Doyle, Emerson,
Hebl, Hong, Milroy, L. Myers, Neubauer, S. Rodriguez, Shankland,
Shelton, Sinicki, Snodgrass, Spreitzer, Stubbs, Vining and Vruwink,
cosponsored by Senators Smith, Erpenbach, Agard, Bewley, Carpenter,
Johnson, Larson, Pfaff and Ringhand. Referred to Committee on Health.

AB544,1,3 1An Act to create 15.07 (3) (bm) 7., 15.735 and subchapter VI (title) of chapter
2601 [precedes 601.78] of the statutes; relating to: creating a prescription drug
3affordability review board and granting rule-making authority.

This bill creates a prescription drug affordability review board, whose purpose
is to protect Wisconsin residents and other stakeholders from the high costs of
prescription drugs. The board consists of the commissioner of insurance and the
following members, all of whom are appointed by the governor for four-year terms:

1. Two members who represent the pharmaceutical drug industry, at least one
of whom is a licensed pharmacist.

2. Two members who represent the health insurance industry.

3. Two members who represent the health care industry, at least one of whom
is a licensed practitioner.

4. Two members who represent the interests of the public.

The bill requires the board to meet in open session at least four times per year
to review prescription drug pricing information. The board must provide at least two
weeks' public notice of its meetings, make the meeting's materials publicly available
at least one week prior to meeting, and provide the opportunity for public comment.
The bill imposes conflict of interest requirements for the board relating to recusal
and public disclosure of certain conflicts. The bill directs the board to access and
assess drug pricing information, to the extent practicable, by accessing and assessing
information from other states, by assessing spending for the drug in Wisconsin, and
by accessing other available pricing information.

Under the bill, the board must conduct drug cost affordability reviews. The first
step in the reviews is for the board to identify prescription drugs whose increase in
wholesale acquisition cost exceeds specified thresholds and other prescription drugs
that may create affordability challenges for the health care system in Wisconsin. For
each identified prescription drug, the board must determine whether to conduct an
affordability review by seeking stakeholder input and considering the average
patient cost share for the drug. During an affordability review, the board must
determine whether use of the prescription drug that is fully consistent with the
labeling approved by the federal Food and Drug Administration or standard medical
practice has led or will lead to an affordability challenge for the health care system
in Wisconsin. In making this determination, the bill requires the board to consider
a variety of factors, which include the following: