During a recent Michigan Legislature meeting on May 21, 2025, lawmakers discussed critical reforms aimed at improving patient access to affordable medications. A significant focus was placed on ensuring that discounts and rebates from manufacturers directly benefit patients at the pharmacy counter, rather than being absorbed elsewhere in the healthcare system.

One of the key proposals highlighted was the need to ban certain patient assistance programs that allow manufacturers' coupons to not count towards out-of-pocket maximums. This practice can leave patients with higher costs throughout the year, undermining the intended financial relief these programs are supposed to provide. Lawmakers expressed a desire to protect patients from these practices, ensuring that any savings from manufacturer discounts are shared with them.

Additionally, the meeting addressed concerns regarding Pharmacy Benefit Managers (PBMs). Lawmakers proposed reforms to limit PBMs from taking a percentage of a medication's value for their services, advocating instead for a flat fee structure. This change aims to eliminate "spread pricing," where PBMs profit from the difference between what they charge insurers and what they pay pharmacies. The committee emphasized that patients should have the freedom to choose their pharmacies without being steered towards specific ones by PBMs.

The discussion also touched on the federal 340B program, which is designed to help low-income patients access medications at reduced prices. Concerns were raised about the program's effectiveness, with lawmakers seeking ways to ensure that patients are the primary beneficiaries. They noted that some states have implemented legislation to improve program integrity, suggesting that similar measures could be beneficial in Michigan.

As the committee continues to explore these issues, the overarching goal remains clear: to enhance healthcare affordability and accessibility for all Michigan residents. The discussions from this meeting reflect a commitment to reforming the healthcare landscape, ensuring that patients receive the financial support they need when accessing necessary medications.