This bill, introduced in the Minnesota Senate as S.F. No. 1876, aims to regulate pharmacy benefit managers (PBMs) and health carriers by requiring them to include lower-cost drugs in their formularies. It establishes rules to ensure that health plan formularies:

1. Inclusion of Lower-Cost Drugs:

   • If a brand-name drug is included in a formulary, the equivalent lower-cost generic drug must also be included.
     
   • If a generic drug is included, the lower-cost brand-name drug must also be included (if applicable).
     
   • If a brand-name biologic drug is included, the equivalent lower-cost biosimilar must also be included.
     
   • If a biosimilar is included, the lower-cost brand-name biologic must also be included (if applicable).
     

2. Quick Addition of Newly Approved Lower-Cost Drugs:

   • When a newly approved generic or biosimilar drug has a lower wholesale acquisition cost than the lowest-cost equivalent drug already on the formulary, it must be added immediately.
     

3. Formulary Structure and Tiering:

   • PBMs and health carriers must structure their formularies in a way that favors the drug (brand-name drug, generic, biologic, or biosimilar) with the lowest out-of-pocket costs for the patient.
     
   • Restrictions like prior authorization, step therapy, or other coverage limitations cannot be applied to the lowest-cost drug.
     
   • Pharmacies must not be restricted from enabling patient access to the lowest-cost drug.
     

The bill would be codified under Minnesota Statutes Chapter 62W and is intended to help patients access more affordable prescription medications by prioritizing drugs with the lowest costs to consumers.