Sen. Urso introduces bill to reduce cost of prescription drugs, protect independent pharmacies
STATE HOUSE — Sen. Lori Urso has introduced legislation that aims to reduce the cost of prescription drugs to Rhode Island patients and taxpayers by banning the use of “spread pricing” by private corporations known as pharmacy benefit managers (PBMs).
The bill is part of a nine-bill package of legislation announced by Senate leadership addressing health care accessibility and affordability.
“Ending spread pricing will lower the cost our medical system pays for prescription drugs, saving Rhode Island taxpayers money even if they don’t regularly use prescription drugs. It will also help our independent pharmacies who are often the hardest hit by a pricing spread that leaves them with reimbursements that barely cover their wholesale medication costs,” said Senator Urso (D-Dist. 8, Pawtucket). “I’m proud to work with my Senate colleagues to make health care more affordable and accessible in Rhode Island, starting with eliminating this common and unnecessary burden on payers and pharmacies.”
The bill (2025-S 0165) would prohibit PBMs from utilizing “spread pricing” in their cost structures related to health care plans. Spread pricing is a practice wherein PBMs charge health plans and payers more for a prescription drug than what they reimburse to the pharmacy, and then keep the difference or “spread.” This practice leads to inflated drug costs borne by payers like private insurers, state Medicaid programs and patients paying out of pocket.
According to the Wall Street Journal, Ohio found this spread came to $5.70 per prescription, and the state could have saved roughly $4 per prescription by eliminating spread pricing.
The practice can also lead to unsustainably low reimbursements for independent pharmacies who are not partnered with a PBM, potentially putting these pharmacies out of business and limiting patient access, particularly in rural and underserved areas.
There has been a huge uptick in the number of states enacting new laws to control PBMs. According to the National Conference of State Legislators, in 2023, one-quarter of state bills to rein in prescription drug prices were aimed at PBMs. Between 2017 and 2023, laws regulating PBMs accounted for more than half of all prescription drug legislation enacted by states.
The National Community Pharmacists Association estimates that PBMs add about 30 cents per dollar to the price consumers pay for prescriptions.
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