Maryland’s Prescription Drug Affordability Board is set to begin limiting costs in the fall, but don’t expect it to make too many waves in the beginning.

During a July 24 meeting of the organization, board members agreed that a cautious approach to setting upper price limits on drugs as the board gets its feet under it is the best idea.

“There are scenarios where the board should feel comfortable saying, ‘Yes, this drug is not affordable, but maybe an upper payment limit isn't the right approach,’” said Andrew York, the executive director of the board.

The careful rollout may be because the board is acutely aware that it may be a model for other states in the future.

The state established the board in 2019, and it has since been figuring out how exactly it will push back against pharmaceutical companies on cost. It’s the first state in the nation to do so.

“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, and what board members want to be careful in exercising at first.

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 10 factors like available discounts, alternatives to the drug and the cost to health plans.

The board still needs to come up with a plan in the coming months to send to the state Legislative Policy Committee before it can begin its work.

The Pharmaceutical Research and Manufacturers of America is currently suing the White House for its attempts to rein in expensive drugs.

The Inflation Reduction Act allows the government to negotiate directly with drug manufacturers on prices for Medicare recipients.

Drug companies say the negotiations will cause a drop in profits and reduce the ability to formulate new, groundbreaking drugs.