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Maryland drug affordability board gets OK to set upper payment limits

FILE- Bottles of medicine ride on a belt at a mail-in pharmacy warehouse in Florence, N.J., July 10, 2018. The Biden administration says the manufacturers of all of the first 10 prescription drugs it selected for Medicare’s first price negotiations have agreed to participate. Tuesday's announcement clears the way for talks that could lower their costs in coming years and gives the White House a potential political win heading into next year’s presidential election.  (AP Photo/Julio Cortez, File)
Julio Cortez
/
AP
FILE- Bottles of medicine ride on a belt at a mail-in pharmacy warehouse in Florence, N.J., July 10, 2018.

Maryland’s Prescription Drug Affordability Board passed a huge benchmark in lowering what the state will pay for some drugs on Tuesday as the General Assembly’s Legislative Policy Committee approved a plan to set upper payment limits on exorbitantly priced drugs in a 16-5 vote.

The Prescription Drug Affordability Board can now set limits on how much state and local governments will pay to drug companies for prescriptions provided by those governments.

“We can and must make some prescription drugs more affordable without upending the marketplace,” said House of Delegates Speaker Adrienne Jones (D-Baltimore County) during the meeting. “Today marks another step and what has been a deliberate and transparent five-year process. I'm confident that the board and its staff will continue to listen to everyone involved as they implement this action plan.”

The upper payment limits are just one of the tools the board has to reduce drug costs, but it is the one with the most bite.

The Board is currently in the process of considering limits on six different drugs.

The drugs include the diabetes and weight loss medication Ozempic and Dupixent, a medication that’s used to treat asthma.

Others selected are Trulicity, Jardiance and Farxiga.

The drugs were chosen out of hundreds of possible options for their high price and their widespread use.

All of the drugs under consideration meet the board’s definition of being cost prohibitive, meaning they cost more than $30,000 a year or $100 a month for generic versions.

The drugs go through a lengthy cost review process to understand the economic impact and reason for the cost before the board decides on using upper payment limits.

“The PDAB has worked diligently to come up with a plan to bring down the cost of high-cost prescription drugs purchased by state and local government, and now it’s time to expand the Board’s authority statewide,” Vincent DeMarco, president of the Maryland Health Care For All Coalition said. “The PDAB has proven that it takes a fair and balanced approach to bringing down drug costs, and the General Assembly should expand the Board’s authority and allow it to bring down costs for drugs purchased by all residents in the state because drugs don’t work if people can’t afford them.”

Lawmakers voting against the decision stated that they feared the limits would be ineffective and not passed on to the consumer.

“We haven't seen this work in any other states,” said Sen. Stephen Hershey (R).

Colorado became the first state to implement upper payment limits on two different drugs. However, those limits were only implemented in July.

“We are talking about this as though we'll see some type of difference when they go to pay for their prescription drugs. And again, that's not correct,” Hershey said.

The law establishing the board states that the board will find ways to reduce costs to the state and to potentially lower drug prices for consumers.

Scott is the Health Reporter for WYPR. @smaucionewypr
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