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Related Topic: Health

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Topic Descriptions

Access 

State policies that affect the way in which patients obtain prescription drugs, including their availability through public or private health facilities and pharmacies. 

Biologics and Biosimilars 

State actions that affect substitution or interchangeability of biosimilars. Includes measures addressing biologic medications.  

Clinical Trials and Right to Try 

State policies addressing the use of experimental treatments by patients, including clinical trials, compassionate use, expanded access and right-to-try legislation. 

Compounding Pharmacy Regulation 

State policies defining and regulating compounding pharmacies. 

Cost Sharing and Deductibles 

Includes consumer-related pricing policies such as formulary tiers, copayments and coinsurance, deductibles, out-of-pocket limits (OOP), discount coupons and price disclosure. 

Coverage in Insurance 

Includes requirements and restrictions affecting state regulated insurance. 

Medicaid Use and Cost 

Medicaid coverage and cost strategies, including preferred drug lists (PDLs), supplemental rebates, managed care carve ins or outs, utilization review, prior authorization, pharmacy and therapeutics committees and other related policies. 

Other Prescription Drug Measures 

Additional prescription drug policy actions not covered in other topics. 

Pharmacy Benefit Managers (PBM) 

State PBM reform efforts, including rebates, spread pricing, maximum allowable cost (MAC) lists, pharmacy auditing standards and appeals processes, pharmacy reimbursement, registration and licensure, and others. See also NCSL’s State Policy Options and Pharmacy Benefit Managers (PBMs)

Pricing and Payment - Industry 

State actions aimed at curbing drug prices, including price transparency, reference rates, public private partnerships, affordability boards and others.  

Prescription Drug Safety and Errors 

State policies requiring safe and secure storage and sales of prescription products, including state-FDA compliance and coordination and synchronization of prescriptions. 

Specialty Pharmaceuticals 

State actions that impact specialty drugs including white and brown bagging policies. 

Utilization Management 

Tools used by payers to manage the use and mix of drugs covered under the prescription drug benefit. States may impose restrictions or allow their use. Includes prior authorization, step therapy or “fail first" policies, non-medical switching, and copay adjustment programs. 

Excluded Topics 

This legislative database does not track bills or laws that: 

Related Resources

Pharmacists and Pharmacy Technicians

Pharmacists and pharmacy technicians prepare and dispense medications to patients. This brief highlights state strategies to define the scope of practice, career pathways and reimbursement for pharmacy professionals.

Community Paramedics

Community paramedics provide emergency medical services, as well as preventative and nonurgent care, in community-based settings. This brief highlights state efforts to recruit and train, license and reimburse EMS clinicians and community paramedics.
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