Delegate Jeff Sickles presented House Bill 2329, a bill aimed at speeding coverage of newly approved generic drugs and biosimilars and requiring clearer public disclosure of plan formularies and restrictions.

The bill would require plans to publish an "up‑to‑date, accurate and complete list" of covered drugs, including tiering and restrictions, in a clearly identifiable way on public websites and to ensure that new lower‑cost generics and biosimilars achieve rapid formulary placement when their net price to the plan is lower. "Policymakers should ensure rapid formulary coverage of new generics and biosimilars and provide that patients receive the full value of lower cost medicines," Sickles told the panel.

Why it matters: supporters argued PBM rebate practices can block patient access to cheaper options. Ashley Van Meter of the Association for Accessible Medicines said manufacturers’ rebates have sometimes led PBMs and plans to favor brand products over lower‑cost generics even where the generic would cut costs dramatically. "We found that if PBMs had used the biosimilar for Humira, there would have been a $6,000,000,000 savings," Van Meter said. Supporters also urged the committee to consider patient cost at point of sale, not just list prices.

Opponents — primarily health plan and PBM representatives — said the bill as drafted would not account for net pricing (rebates and concessions), and that applying the bill without addressing how rebates are used could increase total plan costs. Doug Gray of the Virginia Association of Health Plans testified that "the practical reality is the net rebate is what matters," and noted the state plan and Medicaid programs rely on rebate revenue. Sean Stevenson of the Pharmaceutical Care Management Association told the committee PBMs administer the benefit purchasers select and expressed concerns about mandating coverage decisions.

Committee action: after more than an hour of testimony and questioning, a motion was made and seconded to "gently lay" HB2329 on the table and ask the chair to send a letter to the Health Evidence and Review Commission (HERC) for further review. The motion passed 7‑1. The subcommittee therefore did not advance the bill; it was tabled with a request for HERC review.

The record: advocates emphasized patient savings and access to biosimilars and generics; industry witnesses emphasized the role of rebates and urged caution, saying the state and Medicaid rebate revenue would be affected if the bill were applied without full consideration of net pricing.

Looking ahead: Sponsors and supporters said they want further study of rebate transparency and the mechanics of formulary decisions. The committee’s action sends the policy question to a formal review path rather than producing an immediate statutory change.