The bill aims to reduce prescription drug costs by improving access to biosimilar medicines and interchangeable biological products. It amends several sections of the Revised Code of Washington (RCW) to establish clearer processes for patients and healthcare providers to request exceptions to prescription drug utilization management. Key provisions include requirements for health carriers to provide accessible exception request processes, timely notifications regarding the status of these requests, and criteria under which exceptions must be granted. Additionally, the bill mandates that health carriers cover emergency supply fills and allows patients to remain on their current medications during the exception request process.

Significant changes include the insertion of a requirement that, starting January 1, 2026, health carriers may require patients to try a biosimilar before covering the equivalent branded prescription drug. The bill also modifies existing language regarding the substitution of therapeutically equivalent drugs, allowing pharmacists to substitute interchangeable biological products unless explicitly instructed otherwise by the prescriber. Furthermore, it clarifies that pharmacists may substitute a drug if the consumer's out-of-pocket cost for the interchangeable product is lower than that of the prescribed biological product. These amendments are designed to enhance transparency and streamline the process for accessing necessary medications while ensuring patient safety and adherence to treatment plans.

Statutes affected:
Original Bill: 48.43.420, 41.05.410, 69.41.120, 18.64.245
Substitute Bill: 48.43.420, 41.05.410, 69.41.120, 18.64.245
Engrossed Substitute: 48.43.420, 41.05.410, 69.41.120, 18.64.245