Improves access to lower cost generic and biosimilar drugs and revises certain requirements regarding dispensing of biosimilar drugs by pharmacies.*

A1510 AFI Statement 6/4/26

ASSEMBLY FINANCIAL INSTITUTIONS AND INSURANCE COMMITTEE

STATEMENT TO

ASSEMBLY,
No. 1510

with
committee amendments

STATE
OF NEW JERSEY

DATED:
�JUNE 4,
2026

����� The Assembly Financial Institutions and Insurance
Committee reports favorably and with committee amendments Assembly Bill No.
1510.

����� This bill improves access to lower cost generic and
biosimilar drugs and revises certain requirements regarding dispensing of certain
drugs by pharmacies.

����� Under the bill, existing requirements regarding the
dispensing of biological products by pharmacies are revised to now include requirements
for the dispensing of biosimilars and reference products.� The bill also
removes requirements concerning communications regarding the dispensing of a
biological product between pharmacists and prescribers and includes a new
formulary requirement. Specifically, the bill stipulates that carriers or pharmacy
benefits managers immediately review biosimilar or interchangeable drugs for
inclusion in their formularies if the biosimilar or interchangeable drug is
approved by the federal Food and Drug Administration, marketed pursuant to the
approval, and has a lower Wholesale Acquisition Cost (WAC) to the carrier or
pharmacy benefits manager than the reference product for which it is deemed
biosimilar or interchangeable.� Upon the biosimilar or interchangeable drug�s inclusion
in the formulary of the carrier or pharmacy benefits manager, the carrier or pharmacy
benefits manager must:

����� (1)� immediately make the biosimilar or
interchangeable drug available with the same or more favorable cost sharing,
including actual out-of-pocket cost, relative to the reference product; and

����� (2)� not impose any prior authorization, step therapy
limitation, or other restrictions on a health care prescriber or pharmacy that
makes it more difficult for a covered person to obtain coverage of, or access
to, the biosimilar or interchangeable drug than the reference product.

����� Further, under the bill, certain guidelines are
established to improve patient access to generic and biosimilar drugs in the
State Health Benefits Program, School Employees Health Benefits Program, and
the State Medicaid program.� Among the bill�s provisions, the bill provides a
preference to biosimilars if a covered person or enrollee is prescribed a brand
drug that the covered person or enrollee has not previously been prescribed, if
a biosimilar drug is available.� The bill provides that vendors that contract
with the State Health Benefits Program and the School Employees Health Benefits
Program, and managed care organizations that administer the State Medicaid
program, publish an up-to-date, accurate, and complete list of all covered
drugs in its formulary, including any tiering structure that they have adopted
and any restrictions on the manner in which a drug can be obtained, in a manner
that is easily accessible to covered persons, enrollees, and the general
public.

����� The bill provides that if a generic or biosimilar drug
is licensed by the FDA, is marketed pursuant to the generic or biosimilar
drug�s licensure, and has a wholesale acquisition cost that is less than the
wholesale acquisition cost of the reference listed drug or reference product on
the initial date of the generic or biosimilar drug�s marketing, then vendors
and managed care organizations that provide coverage for the generic drug or
biosimilar�s reference listed drug or reference product at the time of the
generic drug or biosimilar�s marketing date shall:

����� (1)� immediately make at least one biosimilar
available on the formulary on a tier with more favorable cost sharing,
including actual out-of-pocket costs, relative to the reference product; and

����� (2)� not impose any prior authorization, step therapy,
or other limitation on coverage of a biosimilar for which formulary placement
is required under the provisions of the bill, nor impose any restriction on a
pharmacy through which a covered person or enrollee may obtain the generic drug
or biosimilar that makes it more difficult for a covered person or enrollee to
obtain coverage of, or obtain access to, the generic drug or biosimilar than
the reference listed drug or reference product.

����� Finally, the bill provides that a vendor or managed
care organization does not have to provide coverage for a brand drug, generic
drug, or biosimilar if the clinical and pharmacy experts that develop the
formulary determine that the drug or biosimilar is no longer medically
appropriate or cost-effective.

����� This bill was prefiled for introduction in the
2026-2027 session pending technical review.� As reported, the bill includes the
changes required by technical review, which has been performed.

COMMITTEE AMENDMENTS
:

����� The committee amended the bill to:

����� (1)� revise certain requirements regarding the
dispensing of certain drugs by pharmacies;

����� (2)� remove existing requirements concerning
communications regarding the dispensing of a biological product between
pharmacists and prescribers;

����� (3)� require that carriers or pharmacy benefits
managers immediately review FDA approved and marketed biosimilar or
interchangeable drugs for inclusion in their formularies if the drugs have a
lower Wholesale Acquisition Cost (WAC) than the reference product for which the
drug is deemed biosimilar or interchangeable; and

����� (4)� revise the term �therapeutically equivalent.�