Because getting on a formulary can make or break a drug’s profitability, manufactures often offer rebates or other incentives for PBMs to include their products on the list. But there’s no requirement those pricing breaks are passed on to ultimately result in lower costs for consumers.

The bill would also require PBMs to disclose the aggregate amount of rebates received by the PBM, as well as other information about wholesale drug costs.

“If it’s simply a black box, it’s harder for plans to negotiate for better services and lower prices,” state Auditor Troy Downing, a Republican elected last year, told the Senate Business, Labor and Economic Affairs Committee on Tuesday.

The bill saw support from pharmacists around the state, who said deals struck by PBMs have created inadequate networks in Montana that have required people to drive long distances to use an in-network pharmacy. Under the legislation, the state auditor would also have the power to require PBMs provide an adequate and accessible pharmacy network.

Clifford Morris, who own several small pharmacies in the state, said many of his previous customers now have to travel to bigger towns to go to pharmacies that are in-network and have lower drug prices.

“They reason they have to do this is we are not afforded the same contracts large chains,” Morris said.