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Code · Washington · Title 43 — State Government—Executive · Chapter 43.71C

RCW 43.71C.020

275 words·~1 min read·/wa/title-43/chapter-43-71c/43-71c-020·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Beginning October 1, 2019, and on a yearly basis thereafter, a health carrier must submit to the authority the following prescription drug cost and utilization data for the previous calendar year for each health plan it offers in the state:
(1)The twenty-five prescription drugs most frequently prescribed by health care providers participating in the plan's network;
(2)The twenty-five costliest prescription drugs expressed as a percentage of total plan prescription drug spending, and the plan's total spending for each of these prescription drugs;
(3)The twenty-five drugs with the highest year-over-year increase in wholesale acquisition cost, excluding drugs made available for the first time that plan year, and the percentages of the increases for each of these prescription drugs;
(4)The portion of the premium that is attributable to each of the following categories of covered prescription drugs, after accounting for all rebates and discounts:
(a)Brand name drugs;
(b)Generic drugs; and
(c)Specialty drugs;
(5)The year-over-year increase, calculated on a per member, per month basis and expressed as a percentage, in the total annual cost of each category of covered drugs listed in subsection
(4)of this section, after accounting for all rebates and discounts;
(6)A comparison, calculated on a per member, per month basis, of the year-over-year increase in the cost of covered drugs to the year-over-year increase in the costs of other contributors to premiums, after accounting for all rebates and discounts;
(7)The name of each covered specialty drug; and
(8)The names of the twenty-five most frequently prescribed drugs for which the health plan received rebates from pharmaceutical manufacturers.
[ 2019 c 334 s 3 .]
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