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Maryland panel likely to set upper payment limits on two drugs next month

Bottles of prescription medication sit on on shelves in a pharmacy at a Walgreens pharmacy store in Deerfield, Ill., Thursday, July 25, 2024. America's drugstores are testing smaller locations and making bigger bets on health care as they adjust to customers who need them less for convenience. (AP Photo/Nam Y. Huh)
Nam Y. Huh
/
AP
Bottles of prescription medication sit on on shelves in a pharmacy at a Walgreens pharmacy store in Deerfield, Ill., Thursday, July 25, 2024.

Maryland’s Prescription Drug Affordability Board is likely to set its first limits on drug companies in the next month.

The panel may put upper payment limits on two diabetes and heart failure medications after deeming the drugs were too expensive for Marylanders last July.

During a meeting next month, the board could put its first limits on Jardiance and Farxiga for state and local government plans, setting a firm boundary with drug companies on how much Maryland will pay for the drugs based on the maximum fair price.

The maximum fair price is a negotiated reimbursement rate for high-cost Medicare drugs.

By setting an upper payment limit, the board would put a ceiling on how much Maryland will pay for the drugs for plans run by state and local governments.

After one year, the board can move to extend those limits to all health plans in the state.

“These were set after negotiations with the drug corporations,” said Vincent DeMarco, president of Maryland Healthcare for All!. “This is a very smart way to do it. And I think they will also do that for Ozempic.”

The limits could save Maryland $13 million in the long run.

The move comes after a recent poll found 88% of Marylanders thought the state should help control healthcare costs to ensure people have access to the coverage they need.

The board will look at Trulicity and Ozempic next.

Colorado became the first state in the nation to set upper payment limits on drugs last October when it put a ceiling on Enbrel, a drug that treats autoimmune diseases.

Scott is the Health Reporter for WYPR. @smaucionewypr
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