[{"_1":2,"_95":-5,"_96":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",7314925,"mediaKeyId","3426014-afec09ce280076e190f7201efe079b8c","parentId",3426014,"title","House Insurance Committee reports House Bill 4464; PhRMA witness outlines concerns about 340B, PBMs","audioSeconds",1257,"startMs",162000,"endMs",1419000,"viewUrl","/Search/View?dp=1&key=3426014-afec09ce280076e190f7201efe079b8c&start=162&end=1419","thumbnailUrl","https://assets.pipeline.soar.com/3426014-afec09ce280076e190f7201efe079b8c/thumbnail_162000.jpg","articleUrl","/articles/7314925/Michigan/House-Insurance-Committee-reports-House-Bill-4464-PhRMA-witness-outlines-concerns-about-340B-PBMs","mediaUrl","https://secure.pipeline.soar.com/7314925-6c8f58dcee14b308ee03d5c422419be8/orig.mp4?Expires=1770663447&Signature=ina7EgPyx8TNA3TeqPhdGPXBkEJWEbWsl4pvYyxIzS97kJ4y25eeguFsA0tEKiq1H2rQklOX3eNVTCNXld1UlB0-NKMUWiOWz37KHIeHQKecwY11EeAnW9Vm8QhCpncvKrUakLV2ioXU4OdLGrCdEfNEOzso4Lgww4lYaTfUfEC-Ig70r6nh6Nh~U85MRqbYHE5InJ7QzBk6D8Nl7Xc53smFMgd22PceEKu6cCURVVmt6pd6d4NfebzqT0kmcnjMBQz4es89pUZ8w8ybp0kVL50si0roOvl4T1igOx0fPhtHCaUDKyraJ7KJAHBqu5wiajBU8KGnzTZphws~uIH1xQ__&Key-Pair-Id=KUT5TJCACFTXG","author","Michigan Legislature","date","2025-05-21T00:00:00Z","article","The Michigan House Insurance Committee reported House Bill 4464 with a recommendation that it pass after a motion to reconsider and a second roll call; the final committee vote was 10-0 in favor. The panel also heard a presentation from Leslie Wood of the Pharmaceutical Research and Manufacturers of America about prescription drug pricing, pharmacy benefit managers and the federal 340B Drug Pricing Program.

The committee's initial motion to report House Bill 4464 with a recommendation that it pass was made by Representative Aragona and passed on a first roll call (recorded as 9 yays, 0 nays). Representative Carter later moved to reconsider that vote; the motion to reconsider passed (recorded as 10 yays, 0 nays). Representative Aragona renewed the motion to report HB 4464, and the committee again recorded a unanimous roll-call vote in favor (10 yays, 0 nays). The clerk recorded the final outcome as “House Bill 4464 is reported with recommendation.”

During the meeting the committee received a presentation from Leslie Wood, identified in the record as regional vice president of state policy for the Pharmaceutical Research and Manufacturers of America (PhRMA). Wood told the committee that prescription medicines have accounted for a relatively stable share of total health-care spending—“in the range of about 10 to 14% of the health-care dollar”—and said net spending on medicines rose by about 2.3% in 2023. She emphasized the role of generics, saying “Nearly 90% of all prescription medicines are filled with a generic medicine,” and cited large aggregate savings from generics and biosimilars between 2013 and 2022.

Wood focused much of her testimony on pharmacy benefit managers (PBMs) and the 340B Drug Pricing Program. She said three PBM-related companies control roughly 80% of the market and that PBMs influence coverage decisions, prior authorization requirements and patient out-of-pocket costs. On 340B, Wood told the committee that the program has grown substantially, citing an increase from about $12 billion in 2013 to roughly $66 billion in 2023 and saying the program’s expansion has coincided with large hospital markups for certain medicines. She stated that some hospitals mark up common medicines by about 500% and cited examples of higher markups for oncology medicines.

Wood argued that 340B growth can raise costs for employers and state and local governments because drugs dispensed under 340B do not generate duplicate manufacturer rebates for insurers and PBMs. She gave rounded national estimates presented to the committee for additional costs she attributed to the program: roughly $6.6 billion in extra costs to employers and about $1 billion to state and local governments; she identified Michigan-specific figures of about $272 million in extra costs to Michigan employers and about $34 million to state and local government, as presented to the panel. Wood also described contract pharmacy arrangements and stated that a small number of large pharmacies—named in her remarks as Walgreens, Walmart, CVS Health and Accredo—account for a substantial share of contracted 340B pharmacy activity.

Vice Chair Gerter asked how the committee could ensure patients are the primary beneficiaries of 340B. Wood replied that 340B is a federal program and that states can study program integrity and employ tools such as claim modifiers and audits; she cited state reports from Minnesota and North Carolina as examples of state-level analysis.

Committee business aside from HB 4464 included a motion, made by Vice Chair Carter, to approve the minutes from the May 7 meeting, which were approved without objection, and a motion to excuse absent members, also handled without objection. With no further business, the committee adjourned.

The record does not include the text of House Bill 4464, sponsors beyond the committee motion to report, or committee commentary directly describing the bill's provisions; the transcript shows only the committee's motions, roll-call outcomes and the PhRMA presentation as described above.","mediaType","Video","parentTitle","Insurance - 5/21/2025","oneSentenceSummary","The Michigan House Insurance Committee voted to report House Bill 4464 with a recommendation that it pass after a motion to reconsider; the committee also heard testimony from Leslie Wood of the Pharmaceutical Research and Manufacturers of America about prescription drug costs, pharmacy benefit managers and the federal 340B program.","taxTitle","2025 House Legislature MI, Michigan","taxId",77683,"location","Michigan","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6701206,"PhRMA witness tells House Insurance Committee PBMs and 340B growth are shifting drug costs to patients and employers",1049,261000,1310000,"/Search/View?dp=1&key=3426014-afec09ce280076e190f7201efe079b8c&start=261&end=1310","https://assets.pipeline.soar.com/3426014-afec09ce280076e190f7201efe079b8c/thumbnail_261000.jpg","/articles/6701206/Michigan/PhRMA-witness-tells-House-Insurance-Committee-PBMs-and-340B-growth-are-shifting-drug-costs-to-patients-and-employers","https://secure.pipeline.soar.com/6701206-941775c7a4b564830b97ff8e06cbb574/orig.mp4?Expires=1770663447&Signature=Iqma2oqBjx8yd5-QyfCOhsAaPTrDDO1f-QSTRdYS~fzWY8wkXzCXEf1OrzCEVhhrdZ5KcqUjgxd14jmW0iO8iJCDSnCOyCAY0SaolCjXvH4qeaSw8zZc01wYaYeCIXGV0qQgz5rFfThVU3ns6enFDWq4-29kWYoM8l4fWxxzBpbIIdBxx6CIjoHrAOAsH4~Ak8Xnp2HiwNForWS4zh3N~Udl~QQEhy2HYh39cZt2VQhv-LdYdwn-vQugmZZ6eSYcMAGtovoe2qgz2oDktrT1PKzbCuRYuPjIk6sLsgHlpiOr3Fif5Ws0Qi5abKJGgbxP3eiyRGo83iNLZK2oRSONoQ__&Key-Pair-Id=KUT5TJCACFTXG","Leslie Wood, regional vice president of state policy for the Pharmaceutical Research and Manufacturers of America (PhRMA), told the House Insurance Committee that consolidation among pharmacy benefit managers (PBMs) and expansion of the federal 340B Drug Pricing Program have altered how discounts flow through the prescription supply chain and are increasing costs for patients, employers and state governments.

Wood said nearly 90% of prescriptions are filled with generics and that net prescription spending has remained a relatively stable share of total health-care spending, but that large portions of branded-drug spending are captured by intermediaries. \"More than half of every dollar spent on branded medicines goes to entities other than the manufacturer,\" Wood said, adding that PBMs, wholesalers, contracted pharmacies and mandated rebates all take shares of the list price.

Wood cited several quantitative claims: she said net spending on medicines rose about 2.3% in 2023; generics and biosimilar use produced roughly $2.9 trillion in savings between February 2013 and February 2022; and the 340B program's purchasing volume expanded from about $12 billion in 2013 to roughly $66 billion in 2023. She said PBM consolidation gives three companies control of roughly 80% of the market and that four large contract pharmacies'Walgreens, Walmart, CVS Health and Accredo'absorb about half of 340B-related profits in contracted arrangements.

Wood argued that 340B growth can raise state and employer spending because drugs dispensed under 340B cannot simultaneously generate manufacturer rebates to insurers or PBMs (so-called duplicate discounts are prohibited). She said this dynamic costs employers an estimated $6.6 billion nationally and state and local governments about $1 billion nationally; for Michigan specifically she gave figures of roughly $272 million more for employers and about $34 million more for state and local government. Wood said contract-pharmacy mandates could increase costs further and could reduce Medicaid rebates to state plans.

On policy solutions, Wood proposed ensuring manufacturer rebates and discounts reduce patients' point-of-sale costs, protecting patient assistance programs and banning practices that leave coupon savings outside a patient's out-of-pocket maximum. She recommended PBM reforms including flat fees instead of percentage-based payments, banning spread pricing (charging insurers more than pharmacies receive), and prohibiting PBMs from steering patients solely to their own pharmacies.

Vice Chair Gerter asked whether the 340B program had departed from its intended purpose of helping patients. Wood said the program is federal and that many changes would require federal action but recommended state-level integrity measures such as claims modifiers and tracking to confirm eligible patients benefit from the program. \"It is a federal program and so changes really do have to happen at the federal level,\" Wood said.

Committee members did not take action on policy changes during this meeting; the testimony was offered as background for the committee's work on cost-saving measures.","Leslie Wood of PhRMA told the committee that consolidation among pharmacy benefit managers and expansion of the federal 340B Drug Pricing Program are increasing patient out-of-pocket costs and state/employer spending; she offered reforms including passing rebates to patients and PBM regulation.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":91,"_53":92,"_55":56,"_57":58,"_59":93,"_61":62,"_63":64,"_65":94,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6701211,"House Insurance Committee reports House Bill 4464 with recommendation that it pass","/articles/6701211/Michigan/House-Insurance-Committee-reports-House-Bill-4464-with-recommendation-that-it-pass","https://secure.pipeline.soar.com/6701211-fa8818a3c36bf6367678c31780a93a5d/orig.mp4?Expires=1770663447&Signature=aJctpkyHkRk2d3j1wtclcWpLzb1XvzNaNznPO-WQx2z0s9Trz2ixJKC4MGkQ-ucvIPikyb7fDi9nWt8hUG5EDwCiZjeXI1j7IOGw7QN80cL9hlB6VRg1GcxfYDtYRxir4psJfuqkWQ0IlS--d9pTr-9qwkSRrQmBDqL~YB1ZIqP26-CLCY5x3pkMZBdEWFn2HLqOOcVELYurWjyG-XZzk-nuBuuaismMNZu1WP2nZKW9lM38OzWRgmdxp~3a1oyToQRsII4dGWZBZj2jYjYXrPCfHADJjCyYbOYdfdoh4JcC0haZNJ9D95o0he0Fc08Dlv7oNqABlXcXKExYN1y7ug__&Key-Pair-Id=KUT5TJCACFTXG","The House Insurance Committee voted to report House Bill 4464 with a recommendation that it pass after an initial approval and a subsequent motion to reconsider, committee officials said at the meeting.

The vote advances the bill out of committee to the next stage of the legislative process. Committee members took the initial roll call after Rep. Aragona moved to report the bill with a recommendation that it pass; the clerk announced a 9-0 tally and the motion prevailed. Later in the same meeting Rep. Carter moved to reconsider that vote; the reconsideration motion passed on a 10-0 roll call. Rep. Aragona then again moved to report House Bill 4464 with the recommendation that it pass; the clerk announced a final 10-0 vote in favor.

The committee heard a single written comment in support of the bill from Frank Venuto of the American Council of Life Insurers; Venuto did not appear to speak. The committee approved minutes from its May 7 meeting and excused absent members before adjourning.

No amendment text, bill language or committee report language was read aloud in the portion of the transcript covering the votes. The record provided the roll-call responses and tallies but did not include the bill's subject matter or the bill text in the recorded remarks.

Votes at a glance:
- Motion: \"Report House Bill 4464 with recommendation that it pass.\" Mover: Rep. Aragona. Initial roll call announced by the clerk: 9 yays, 0 nays, 0 pass; motion prevailed. Motion to reconsider (mover Rep. Carter) passed on a 10-0 roll call. Final report motion carried 10-0. No seconds were recorded in the transcript.

The committee did not take further action on the bill during the recorded meeting; the next procedural step is placing the bill on the House calendar per standard legislative practice.","The Michigan House Insurance Committee voted to report House Bill 4464 with a recommendation that it pass after an initial approval, a successful motion to reconsider and a second roll call that changed the tally to 10-0 in favor.","actionData","errors"]

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House Insurance Committee reports House Bill 4464; PhRMA witness outlines concerns about 340B, PBMs

PhRMA witness tells House Insurance Committee PBMs and 340B growth are shifting drug costs to patients and employers

House Insurance Committee reports House Bill 4464 with recommendation that it pass