Virginia Prescription Drug Affordability Board bill advances as governor seeks changes
Virginia lawmakers are again advancing a Prescription Drug Affordability Board bill, while Gov. Abigail Spanberger seeks amendments. The measure would create a board to analyze drug pricing and apply federal caps to state-regulated plans.
Virginia’s multi-year attempt to establish a Prescription Drug Affordability Board is again advancing in the legislature, but it remains unclear if it will finally become law this time around. The bipartisan proposal would create a special board of medical and health experts tasked with analyzing data and ensuring federal drug pricing caps are applied to state-regulated health insurance plans.
The legislature approved the measure for the past two years, but former Gov. Glenn Youngkin vetoed it, citing concerns with stifling medical innovation and attracting pharmaceutical companies to the state. Gov. Abigail Spanberger has not confirmed whether she would sign, amend or veto the measure if lawmakers send it to her desk, and is now seeking amendments before she is fully on board with the idea.
Should the bills be signed into law, they would establish an advisory panel to examine data and ensure federal drug pricing caps are applied to state-regulated health insurance plans. Another amendment removes language mirrored after federal legislation aimed at curbing drug prices. Modeled after federally approved cost reductions to certain drugs for Medicare recipients, the bill has been described as “simply extending that.” Federal approvals already apply to 10 drugs since the beginning of this year and another 15 are expected to take effect next year.
Advocates caution that a proposed reenactment clause prevents the bill from having the cost-savings teeth it was created to have. One patron said he does not support the amendments, making it possible the bill could be returned to the governor to consider signing as it came to her.
The proposal is now often referred to by lawmakers and advocates as the Affordable Medicine Act. The legislation has been carried for several years in a row, and lawmakers said they are continuing to work with stakeholders and the administration to refine the bill and make sure it is effective.
Opponents have called the measure “highly flawed” and warned that because states fund the setup of boards, taxpayers will carry those costs. Lawmakers backing the bill have said they are studying where similar boards have gone right and where they have gone wrong.
Maryland became the first in the nation to set up a PDAB in 2019, but it did not make much progress until recently. The 2020 COVID-19 pandemic led the state to pull the board’s earmarked funding and not assign board members; after funding was released, it took the board a year and a half to set up a regulatory framework and settle on six drugs to consider for cost reduction.
Colorado’s PDAB established a cap on Enbrel, a drug used for various autoimmune disorders, but the cap has not yet taken effect. After staving off a previous legal challenge, Colorado’s board is facing a fresh lawsuit from the drug’s manufacturer.
Virginia’s board could aim to align prices with drugs that have already garnered federal limits through Congress’ 2022 Inflation Reduction Act. That federal law applied to Medicare-covered drugs, while Virginia’s board could be more broad. Lawmakers will reconvene on April 22 and 23 to review amendments to legislation, potentially challenge vetoes and finalize the state budget.