Everyone can agree that healthcare costs are too high, and prescription drug prices are a major reason why. That is why I am happy to co-sponsor legislation written by Rep. Todd Novak (R-Dodgeville), nicknamed “Cole’s Act,” named after Cole Schmidtknecht from Appleton. Cole was 22-years-old when he went to the pharmacy for a routine pickup of his inhaler. He was shocked to learn that the price of his inhaler had increased from $66 to $539 without any prior notification. Cole decided to delay the purchase for a little bit so that he could pay his rent. Tragically, just a few days later, Cole died from an asthma attack. Sadly, many Wisconsinites have faced similar situations, encountering sudden increases in the cost of essential medication.

Cole’s Act addresses this problem, in addition to tackling predatory pricing practices commonly used by Pharmacy Benefit Managers (PBMs), a little-known third-party entity, that lead to higher drug prices.

PBMs are the middlemen in the prescription drug supply chain. They work with drug manufacturers, insurers, and pharmacies to determine which medications are covered, how much patients pay, and how pharmacies are reimbursed. The idea behind PBMs is not a bad one. In theory, they should leverage their buying power to deliver savings for insurers and pharmacies that would be passed on to consumers. Unfortunately, their growing influence has placed significant pressure on small, local pharmacies as well as patients.

Local pharmacies are an important part of our healthcare system. They provide a convenient place to pick up prescriptions, offer advice on how to safely take medicine, and serve as a trusted location for vaccinations. Yet, because of the influence of PBMs, our local pharmacies are struggling. These middlemen often steer patients towards large mail-order or corporate-owned pharmacies. PBMs also reimburse local pharmacies below cost, which has forced many across the state to close their doors.

Cole’s Act aims to level the playing field. It would require PBMs to reimburse local pharmacies at a fair rate so they can keep their doors open and continue serving rural areas. The bill would also prevent sudden mid-year changes in drug coverage, ensuring patients are not blindsided by unexpected cost increases. And it would guarantee that funds intended to support low-income and uninsured patients reach the people who need help most.

I will continue working to make healthcare more affordable and accessible. This legislation is a great step towards helping patients, reducing drug costs, and protecting local, rural pharmacies. Red and blue states across the country are passing legislation similar to this to protect patients and independent pharmacies.

If you need assistance with any state-related matters, please call my team at the State Capitol – 608-266-0703 – or email me – Sen.Marklein@legis.wisconsin.gov. My team is ready and willing to help navigate your state government, clear obstacles, and receive your input.