Senator Wiener Responds to Governor’s Veto of Pharmacy Benefit Manager (PBM) Bill
SACRAMENTO – Governor Gavin Newsom vetoed Senator Scott Wiener’s (D-San Francisco) Senate Bill 966, legislation to rein in anticompetitive practices pharmacy benefit managers (PBMs) are using to drive up prescription drug prices and forcing independent pharmacies out of business. As a result, California remains one of the only states to leave the industry, which controls virtually all prescription drugs on the market, essentially unregulated. As a result, Californians will continue to pay more for health care and will continue to have limited access to their neighborhood pharmacies.
Recent New York Times and Wall Street Journal exposés, investigations from bipartisan members of Congress, and a lawsuit from President Biden’s Federal Trade Commission (FTC) have shone a light on PBM abuses. PBMs are steering patients away from pharmacies in their communities, cutting cheap generic drugs out of health plans’ coverage, and misleading patients about their benefits. SB 966 would have enacted some of the strongest protections in the country against these damaging practices that contribute to rising drug prices.
“PBMs are driving up health care costs, destroying neighborhood pharmacies, and preventing Californians from receiving health care at their local pharmacies. Today’s veto is a huge missed opportunity to control prescription drug costs and protect consumers from predatory behavior by PBMs.” said Senator Wiener. “The evidence — from Congress and from major exposes by the Wall Street Journal and New York Times — is clear: PBMs driving up the cost of prescription drugs and reducing consumer choice. That’s why this issue attracts such broad bipartisan support and why this veto is a black mark against California’s leadership to contain healthcare costs.
“This veto is nearly certain to kneecap the Governor’s own CalRx plan to have the state directly manufacture affordable generic insulin. As long as PBMs remain virtually unregulated, and as long as they have an incentive to push expensive name brand drugs, the health plans they control will not cover CalRx’s insulin and most patients won’t access it. Californians will continue to suffer from skyrocketing drug prices, including the 3 million Californians living with diabetes.
”This veto is a massive fail.”
“We are incredibly disappointed that the Governor chose to veto this vital piece of legislation. This bill enjoyed significant bi-partisan support and was championed by healthcare providers and patient advocates, we are all devastated by the veto,” says Melissa Kimura, PharmD, President, California Pharmacists Association. “Community pharmacies and patients will continue to suffer at the hands of PBMs unless Congress acts. I would be remiss if I didn’t acknowledge the fearless leadership of Senator Wiener and send a heartfelt thank you to every legislator who stood up to the tremendous amount of opposition this bill received.”
“The CA Chronic Care Coalition is grateful to Senator Wiener and the legislators that stood with California patients in voting to advance SB 966. This bill was our top priority, as patients are regularly harmed by the State’s lack of oversight of PBMs. By creating transparency, commonsense safeguards, and properly aligned incentives, SB 966 would improve patients’ access to critical care and make health care more affordable,” stated Liz Helms, President and CEO of the California Chronic Care Coalition. “We are disappointed that the bill was vetoed, representing a victory for predatory middlemen and corporate profits. For years, we have pursued piecemeal solutions to curb the worst PBM abuses. However, it is clear that without sufficient insight into the PBM industry, PBM’s will continue to morph in ways that make access more difficult and out-of-pocket costs more burdensome. We will continue the fight to ensure equity and access in California’s health care system.”
“It is deeply disappointing to see SB 966 not signed into law by Governor Newsom. Prescription drug affordability is a top concern among many in our community living with and at risk for HIV. This bill would have helped to tackle the rising costs of prescription drugs through pro-consumer requirements and regulations of PBMs. It is unsustainable for the costs of lifesaving medications to continue to rise, as these affordability issues only deepen equity concerns in treatment and care. We are committed to supporting further efforts that regulate the fees and added costs passed on to consumers and patients” says Tyler TerMeer, PhD, CEO of San Francisco AIDS Foundation.
"We are deeply disappointed by the Governor's decision to veto the bill that would regulate pharmacy benefit managers and curb skyrocketing drug costs. This legislation was crucial for ensuring fair access to medications and health services, especially for the LGBTQ Californians, who already face healthcare challenges and disparities. This outcome perpetuates the barriers to necessary care, exacerbating inequities–and leaving our community vulnerable to additional harm. We have to put a stop to profits over the lives of people, particularly those in marginalized communities," said Terra Russell-Slavin, Chief Impact Officer for the Los Angeles LGBT Center.
Last year, Governor Newsom vetoed SB 90, a bill authored by Senator Wiener and supported by the American Diabetes Association which would have capped the price of insulin at $35/month.
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