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Investor Presentaiton

drug manufacturers. Oregon took some early steps to reduce prescription drug costs, but progress since then has been minimal compared to other states One early step Oregon took was the creation of the Oregon Prescription Drug Program (OPDP), which is administered by OHA. OPDP was established in 2003. Currently, the program purchases prescription drugs, reimburses pharmacy claims, creates a standard preferred drug list, and operates a prescription discount card program. 18 One of OPDP's goals is to ensure the most effective drugs are available at the best prices to the insurers who use the program. OPDP eventually joined Washington State and formed a consortium in 2006, expanding the purchasing power of the program. In 2022, the State of Nevada joined the consortium and expansion to other states continues to be explored. Currently, the program administers pharmacy benefits for 13 different institutions and programs across three states, including the State Accident Insurance Fund, Oregon Health and Sciences University, and the State Hospital and covers over 225,000 lives just within Oregon. CCOs can also choose OPDP to administer pharmacy benefits; however, only one has chosen to do so. Oregon's PBM legislation In the last 10 years, 28 PBM reform bills have been introduced, but only seven have passed. In 2019, legislation was passed stating PBMS could not prohibit a network pharmacy from offering delivery of prescription drugs to consumers. In the same bill, the Legislature prohibited PBMs from restricting or penalizing a network pharmacy from informing a customer of the difference between their out-of-pocket cost and the pharmacy's retail price for the drug. This was implemented in Oregon after several other states had passed similar legislation. Many other states are currently making inroads to dealing with spread pricing and PBM transparency issues as well. Although the Legislature has demonstrated bipartisan interest in reforming PBMs, other issues have taken priority, including the pandemic and several natural disasters. The pharmaceutical industry also has strong lobbying power in the Oregon Legislature and has donated more than $600,000 to various campaigns and funds over the past five years. The pharmaceutical supply chain is very complex and can be difficult to understand. Since pricing and cost information can be considered proprietary, policymakers do not have enough information available to enact meaningful change for some issues. There are three main areas other states have focused their PBM legislation on: patient protections, pharmacy protections, and transparency. With the national spotlight currently focused on both drug manufacturers and PBMs, Oregon's Legislature made some progress during the 2023 session. Bills were passed requiring PBMs to report some information to DCBS, pharmacy retroactive fees and payment reductions were restricted, and recurring surveys of pharmacy dispensing costs were implemented. While these are improvements, the Legislature should do more to protect patients and community pharmacies. 18 ArrayRx is Oregon's prescription discount card program, which has no income restrictions or membership fees, and is available to anyone living in Oregon. Oregon Secretary of State Report 2023-25 | August 2023 | page 15
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