Larry Zarzecki, a resident of White Marsh, has Parkinson’s disease. Over the span of three years he went through his IRA and sold his house in order to cover the out-of-pocket costs for his drugs.

“Each year, prescription drugs became more and more and more expensive,” Zarzecki said. “Over the past few years, it's gotten so out of hand with the cost of the other prescription drugs that I take to function.”

Zarzecki is one of the 25% of American who have trouble affording their prescription drugs due to high out-of-pocket costs, according to the Kaiser Family Foundation.

Americans spend an average of $1,300 a year on their prescription medications. That’s compared to about $550 for other comparable countries.

Maryland will soon be the first state in the country with a functional Prescription Drug Affordability Board, aimed at bringing down the high prices of some prescription drugs.

The state established the board in 2019 and it’s since been figuring out how exactly it will push back against pharmaceutical companies on cost.

“The idea behind these boards is for states to think about what a fair price would be that can increase access to these drugs for patients within the state,” said Rachel Sachs a professor of health law at Washington University in St. Louis.

The teeth behind Maryland’s affordability board is the ability to set upper payment limits, a power given to it by the state legislature.

The limits are a solid monetary topline that insurers in the state will not pay more than for a specific drug.

Maryland’s drug affordability board will conduct cost reviews of drugs that seem too expensive.

For example generic drugs that increased in price by 200% over the last year, generic drugs that cost more than $100 a month or brand name drugs that launch at $30,000 or more a year.

During the review the board will look at ten factors like available discounts, alternatives to the drug and the cost to health plans.

Andrew York, the executive director of the board, said the board will work closely with manufacturers to understand the challenges they face as well.

“Then there's the ultimate determination of after a drug undergoes a cost review, the board makes the determination of if it causes an affordability challenge or not,” York said.

The model is based on the complex negotiations within the medical system.

“Nobody pays what they are charged, health insurers establish payment rates for what they will pay a hospital for a certain procedure or certain illness,” said Jane Horvath, a state consultant on drug issues. “Insurers will set rates for what they'll reimburse pharmacies for generic drugs, for instance. A prescription drug affordability board builds on those models that already exist at the state level."

Other states are now catching on. Six states including Colorado and Oregon now have their own boards, but still have yet to perform cost reviews.

However, not everyone thinks the boards will help patients.

“Anytime that a board of government officials make unilateral decisions about people's health care, it can create a situation where you have people making choices, and coming between the decisions between a doctor and a patient,” said Priscilla Vanderveer, the vice president of public affairs at Pharmaceutical Research and Manufacturers of America, an industry group representing drug companies.

But people like Zarzecki say a drug affordability board could provide universal standards on drugs.

He’s already relying on rebates and coupons provided by manufacturers and says they are making a big difference.

“It began a really positive change in the way prescriptions are being look at. It's allowed me as a person to afford to buy my two grandsons Christmas presents this year,” he said. “ It was the first time since I can remember that I've been able to really enjoy Christmas with them.”

Zarzecki said he hopes the board can make decisions for drugs that don’t offer rebates or coupons to help plenty of other Marylanders.

The board is currently opening its cost review process up to public comment and plans to take up its first drugs this fall.