Maryland’s Prescription Drug Affordability Board took one of its biggest steps in regulating drug prices today as it voted on an upper payment limit plan for drugs bought by state and local governments.
The board has been working for more than a year on how it will implement the limits and on what drugs it will first use them on.
The structure still needs to be approved by the General Assembly’s Legislative Policy Committee. By law, the committee has 45 days to approve the plans.
“The board’s plan is similar to what is happening at the federal level with Medicare,” said Vincent DeMarco, president of Maryland Healthcare for All! a drug affordability group. “The federal plan, for the first time, allows Medicare to negotiate with the drug corporations. Now our board will be able to do that for state and local governments. They can say to the companies ‘You could charge whatever you want, but we're only paying a reasonable amount.’”
The state established the board in 2019, however its work was pushed off due to funding issues.
“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.
DeMarco said with the upper-payment limit structure in effect, the board now can focus on the drugs that need to be negotiated instead of coming up with the proper way to limit price.
In April, the board selected a handful of drugs it thinks fit the criteria of being cost prohibitive to Marylanders who are on state-run health insurance plans.
The drugs include the diabetes and weight loss medication Ozempic, ADHD drug Vyvance and Dupixent, a medication that’s used to treat asthma.
Others selected are Trulicity, Jardiance, Farxiga, Skrizi and Bikarvy.
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.
