Prescription drugs prices establishment subject to the Medicare Drug Price Negotiation Program
SF5302 would create a new Minnesota law governing the pricing of certain prescription drugs that are subject to the federal Medicare Drug Price Negotiation Program. The bill defines a “maximum fair price” as the price set by the U.S. Department of Health and Human Services for a referenced drug and generally prohibits manufacturers from accepting payment above that amount for sales of those drugs intended for use in Minnesota, while allowing additional pharmacy dispensing fees and provider administration fees. It also requires health plans and pharmacy benefit managers to reimburse pharmacies at no less than the maximum fair price or NADAC, whichever is greater, plus any dispensing fee.
The bill further requires health plans and pharmacy benefit managers, upon request, to provide detailed financial information to the Minnesota Prescription Drug Affordability Board about fees, rebates, network access charges, shared savings, and final payment details related to referenced drugs. In addition, it prohibits manufacturers from withdrawing a referenced drug from sale or distribution in Minnesota to avoid the price limits unless they give 180 days’ written notice to the commissioner of health. A manufacturer that violates that withdrawal restriction would face a civil penalty of at least $100,000 or the annual savings associated with the drug, whichever is greater. The law would take effect January 1, 2027.
The bill would add a new section to Minnesota Statutes, chapter 62Q, creating state-level enforcement around federally negotiated Medicare drug prices. It would directly affect drug manufacturers, health plans, pharmacy benefit managers, pharmacies, and the Minnesota Prescription Drug Affordability Board by setting reimbursement floors, limiting manufacturer pricing above the federal maximum fair price, and requiring disclosure of pricing and fee data. It also gives the commissioner of health authority to assess penalties for prohibited drug withdrawals from the state market.
Based on the bill text and the absence of recorded committee testimony or votes in the provided materials, the bill appears to be framed as a consumer-cost and affordability measure with a regulatory approach to ensuring that federal drug price negotiations are reflected in Minnesota. The overall tone is supportive of lower prescription drug costs and greater transparency in drug pricing. No formal opposition or recorded debate is available in the provided context.
The main potential points of contention are likely to be the limits placed on manufacturers’ pricing and market access, the reimbursement requirements imposed on health plans and pharmacy benefit managers, and the broad financial disclosure obligations to the Prescription Drug Affordability Board. Manufacturers may object to the penalty structure and the restriction on withdrawing drugs from the Minnesota market, while insurers and PBMs may resist the mandated reimbursement floor and reporting requirements. Supporters would likely emphasize affordability, transparency, and preventing companies from circumventing federal price negotiations.