Bill
S 875
Creates a Massachusetts Prescription Drug Affordability Board to review prices, require early notices for new drugs/price hikes, and boost transparency for patients and payers.
Status & Procedural History
- Filed in the Massachusetts Senate (Senate Docket No. 2055) and presented by Sen. Edward J. Kennedy (First Middlesex). Filed 1/17/2025; introduced in session as S.875 (record also shows introduction/read and referral on 03/06/2025).
- Referred to relevant committees (Health Care Financing; later noted in some records as placed on Senate calendar and referred to Codes). Hearing scheduled 06/02/2025 (Gardner Auditorium). Legislative record in the materials is partially truncated; see “Legislative Actions” for dates listed in the docket.
Purpose / Intent
- The bill seeks to increase transparency and assess affordability of prescription drugs, biologics, and biosimilars by specifying terms, empowering a state-level review body (the “Board”), and imposing notification/reporting and confidentiality rules tied to affordability reviews and early notices.
Key Provisions (as shown in the provided text)
- New definitions added to chapter 6D (Section 1 et seq.), including:
- “Affordability Challenge” — situations where the Board finds that drug costs exceed therapeutic benefit or are unsustainable for consumers or health systems.
- “Biologic” and “Biosimilar” — defined with reference to federal biologics licensing statutes.
- “Board” — the Prescription Drug Affordability Board (referenced as established under Section 3B).
- “Brand name drug,” “Pipeline drug,” “Prescription Drug,” “Early notice,” “Pharmacy Wholesale Distributor,” “ERISA Plan,” and “Participating ERISA Plan.”
- Expanded and clarified definition of “Pharmacy benefit manager” to list specific PBM activities (claims processing, utilization review, prior authorization processing, formulary administration, mail/specialty pharmacy, cost containment, etc.), and to exclude certain in‑house plan functions when the sponsor is a licensed carrier.
- Introduces “Early notice” concept requiring advanced notification by manufacturers for (i) new products coming to market and/or (ii) price increases (see cross-reference to subsection (b) of section 15A).
- Permits ERISA‑qualified plans to elect to participate in certain requirements and restrictions (via the “Participating ERISA Plan” definition) — establishing an opt‑in mechanism for self‑insured plans.
- Revises confidentiality rules (replacement of section 2A): the commission (or Board/commission performing these functions) must keep confidential nonpublic clinical, financial, strategic, or operational documents submitted in connection with activities authorized under multiple sections (e.g., affordability improvement plans, early notification, etc.) and may not disclose without consent (text truncated in provided material).
Who Would Be Affected
- Pharmaceutical manufacturers (by early notice and reporting expectations).
- PBMs, pharmacy wholesale distributors, and pharmacies (by definitional and regulatory clarifications).
- Health carriers, state purchasing entities, public and private health care systems, and consumers (through affordability reviews and any downstream pricing/coverage implications).
- ERISA plans — the bill creates a mechanism for ERISA plans to opt into state requirements (which may affect plan participation in state programs or processes).
Limitations / Notes
- The provided document is truncated; the full bill text (sections following the reworked section 2A and the referenced sections 3B, 15A, 24, etc.) is not included here. Those sections likely contain the Board’s full powers, procedures for affordability reviews, reporting timelines, remedies or cost‑containment mechanisms, and penalties, which are necessary to fully assess operational impact.
- Metadata in the prompt contains inconsistent sponsor listings (names of U.S. Senators) that appear unrelated to the Massachusetts bill text; primary sponsor in the bill text is Sen. Edward J. Kennedy.
Potential Impacts (based on available text)
- Increases state tools to identify drugs posing affordability challenges and to require manufacturer reporting and early notification.
- Could create new compliance / reporting obligations for manufacturers, PBMs, and distributors.
- May change how state purchasing entities and participating ERISA plans handle drug procurement and benefit design; intended to improve transparency and inform policy responses to high prices.
Compiled from official sources — confirm details with the bill’s official record.
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