Prescription Drug Review Boards
There continues to be a lot of interest in prescription drug review boards (PDABs) at the state level. These boards examine the most expensive drugs in a state and then go through a process to determine if they are unaffordable. For those drugs deemed unaffordable, the PDAB can institute upper payment limits, which can regulate a drug’s selling price or reimbursement amount in a state.
Colorado, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Ohio, Oregon and Washington have all created PDABs. Although the ACR understands the appeal of implementing cost-saving measures, PDABs run the risk of creating access issues and could result in targeted drugs being removed from state formularies. PDABs could also lead to a two-tiered health system, in which those who can afford to pay out-of-pocket for an unaffordable medication can obtain it and those who can’t are out of luck.
It’s important to note that none of the states that have enacted PDAB legislation have completed the review process yet. The PDAB still lacks proof of concept, and the full impacts on patient access are poorly understood. Because of that, the ACR recently submitted a letter to Gov. Glenn Youngkin of Virginia on the PDAB bill currently on his desk (HB 1724) and urged the state to take a wait-and-see approach on PDABs. We are also working with rheumatologists in Colorado on a strategic approach to the next PDAB hearing so the concerns of rheumatologists are heard by policymakers.
Expanding Funding for Fellowships & Loan Forgiveness
Expanding access to loan forgiveness programs and increasing fellowship funding is a key goal of the ACR’s workforce initiatives. The Georgia Senate has passed SB 130, which would accomplish both goals. The bill is sponsored by the majority and is currently in the House. It would make fellows eligible for state service-based loan forgiveness programs. Importantly, it would also make fellowship slots eligible to receive $10,000 per year in state funding payable to the fellow’s designated institution. The ACR is fully supporting this legislation, and we hope to be able to encourage other states to take the same approach.
What’s Next
Many states are entering the final weeks of their legislative session. The pace of legislation will be picking up dramatically and so will our engagement on the issues that are important to our members. It is important to remember that even if a bill doesn’t pass this year, all is not lost. In most states, bills will carry over to next year. We will continue to work with our partners to build broad coalitions to support those pieces of legislation in hopes that we can move them forward in the next year. For other states, sessions are just beginning or will be running through the rest of the year.
