The West Virginia Offices of the Insurance Commissioner recently updated its analysis of its pass-through rebate program with a pharmacy reimbursement requirement of NADAC plus a professional dispensing fee. West Virginia was the first state to require NADAC+ in the commercial market via legislation in 2022.
The new analysis, available to read here, looks at three years of data. Consistent with previous years’ analysis, the combination of pass-through rebates and cost-based reimbursement was an actuarial wash, and premium increases were blunted.
In a recent PBM reform hearing in Kansas, the West Virginia OIC submitted testimony about its experience implementing the policy. NCPA encourages members and partners to utilize the analysis in their state-level advocacy and to pull talking points from the testimony, which you can read here.
