HELENA – Beginning this fall, all Montana physicians will be able to dispense medications they prescribe to patients, not just those whose offices are at least 10 miles away from a pharmacy.
The catalyst for passing the legislation was a June 2020 lawsuit by the Institute for Justice challenging the constitutionality of the ban along with an acknowledgement by the chair of the Montana Pharmacy Association that the organization had previously opposed similar legislation to protect its own business model.
The bill had nearly unanimous support in the legislature and was signed into law by Gov. Greg Gianforte on Tuesday.
The lawsuit forced the Montana Pharmacy Association to work with drafters on the bill because the association was concerned about how the lawsuit would be decided, said Logan Tinsen, chair of the association. The bill requires physicians who dispense medication to be regulated like a pharmacy and requires opioids to be dispensed by pharmacies.
“In the end, pharmacists understand the importance of taking care of patients and that means being amendable to change and looking ahead and not being so (protective) of our profession,” Tinsen told a Senate committee in February.
“Montana did the right thing by allowing patients to decide for themselves where to purchase their prescribed medications,” said Josh Windham, an attorney for the Arlington, Virginia-based Institute for Justice. “The fact that the Montana Pharmacy Association said the quiet part out loud — that these bans have always been motivated by economic protectionism — should inspire the few remaining states with similar bans to follow suit.”
The Institute for Justice has filed a lawsuit challenging a similar ban in Texas. Texas and Massachusetts have legislation pending that would lift their bans, Windham said. New York, New Jersey and New Hampshire also effectively ban doctors from dispensing prescription drugs, he said.
The physician plaintiffs in the Montana lawsuit all practice as direct primary care providers, meaning patients have contracts with them for basic medical care such as annual checkups and vaccines. The doctors have said they moved to direct primary care to eliminate insurance from the equation and also sought to dispense some medications.
“This legislation is another step toward achieving quality outcomes in medicine,” plaintiff Dr. Cara Harrop of Polson said in a statement. “Patients have the option of getting medication in an affordable and transparent model, doctors can be better informed about their patients’ compliance with their prescribed treatment plans, and pharmacists, where appropriate, can continue serving as consultants on the healthcare team.”
The bill takes effect on Oct. 1, its sponsor, Republican Sen. Cary Smith, said Thursday.
Gianforte, a Republican, has signed another bill aimed at reducing prescription prices by allowing the state to regulate pharmacy benefit managers, the middlemen between drug companies and pharmacies that help insurers manage their prescription drug benefits.
It’s not always clear the wholesale costs of drugs and what kind of rebates and other considerations the PBMs receive to include certain drugs in their formularies, which are lists of medications that insurance policies will cover.
“A lack of transparency into PBMs’ practices has long contributed to the rising costs of prescription drugs,” Gianforte said in a statement Wednesday. “By increasing oversight of the middlemen in the pharmaceutical supply chain, we’ll bring generic drugs to market faster, increase drug pricing transparency, and promote accountability.”
That bill takes effect on Jan. 1, 2022.