More States Eye Drug Affordability Boards, PBM Regulations

 
• By Peter Johnson
  
Generate a summary of this article
Listen to this article
Beta

Some states are adding more ‘muscular attributes’ to their Rx boards, such as setting upper limits based on the pending Medicare prices, but federal ERISA legislation still limits the boards’ impact.

50 states of pills
States are still in the early stages of implementing their drug pricing boards. • Source: Shutterstock

PBM and drug pricing regulation will continue to be hot topics at the state level after several years of busy lawmaking, experts predict, even as PBM reforms appear stalled in Congress. They predict that more states than ever will continue to embrace or pursue policies like drug affordability review boards.

Key Takeaways

  • Over 100 drug pricing bills are under consideration in 29 states, much of it based on NASHP model legislation.

“I do think the momentum is still strong, because states have the ability to do a lot more,” Kate Sikora,...

Pink Sheet Podcast

Learn what's happening at the US FDA. On the go.

Derrick Gingery and the team bring you a weekly "Drug Fix".

SpotifyApple PodcastsWebsite

More from Pricing Debate

PS-MarketAccess (Premium-2): Why Financial Scammers Are So Successful Targeting Doctors

 
• By Nabil

Doctors are increasingly falling victim to financial scams due to their high incomes, busy schedules, and trust in professional networks. Recognizing the tactics scammers use and the reasons behind physicians’ susceptibility is essential for protecting medical professionals.

Senate Hearing On Ozempic, Wegovy Highlights Concerns About PBMs, International Price Disparities

 
• By Cathy Kelly

Senate HELP Committee chair Sanders trying to broker a deal between Novo Nordisk and the major pharmacy benefit managers that will lead to lower list prices.

‘Alternative' PBMs Say Vertical Integration Unfairly Carving Them Out Of The Game

 
• By Sarah Karlin-Smith

Alternatives to the top pharmacy benefits managers argue health plan-PBM integration is leading to anti-competitive tactics that make it impossible for some employers to switch PBMs.

US FDA Biologics Designation As Price Protection: Lilly Charts New Course With Retatrutide

 
• By Cathy Kelly

An effort to change the US Food and Drug Administration’s conclusion that its obesity treatment candidate retatrutide is a drug and not a biologic could give the product more time with unrestricted pricing in Medicare, among other benefits.

More from Market Access

analysis

Shot Across The Bow? Express Scripts Lawsuit Seeks To Derail Fall-Out From FTC PBM Report

 
• By Cathy Kelly

Pharmacy benefit manager sues Federal Trade Commission claiming chair Khan has orchestrated a campaign against PBMs that is not based in fact.

‘Alternative' PBMs Say Vertical Integration Unfairly Carving Them Out Of The Game

 
• By Sarah Karlin-Smith

Alternatives to the top pharmacy benefits managers argue health plan-PBM integration is leading to anti-competitive tactics that make it impossible for some employers to switch PBMs.

UK MHRA First-Half New Drug Approvals Show Overwhelming Use Of EU Reliance Procedures

 
• By Ian Schofield

The UK regulator approved 16 medicines containing a new active substance in the first half of this year, while the European Commission issued marketing authorizations for 20 NAS-containing drugs.