Latest news with #PDABs
Yahoo
21-03-2025
- Health
- Yahoo
Virginia's Prescription Drug Affordability Board proposal awaits Youngkin's action
(Photo by Angela Breck for Maryland Matters) As a bill representing a yearslong quest to create a Prescription Drug Affordability Board awaits Gov. Glenn Youngkin's signature, veto or amendments in the coming days, opponents hope it will once again meet his veto pen while supporters hope he's had a change of heart. If enacted, the legislation would create an independent, nonpartisan board of medical and health experts tasked with analyzing data to set payment limits on drug prices within state-sponsored health plans. Youngkin previously described the proposal as 'noble in its intent' but warned it could 'limit access to treatments and hinder medical innovation' when he rejected last year's proposal. Del. Karrie Delaney, D-Fairfax, countered that pharmaceutical companies could fund innovation without raising drug prices by trimming costs in areas like advertising or executive salaries. 'I think all one needs to do is look at the budget for these companies,' she said in a press conference earlier this year. 'If a big pharma company needed to cut its budget, I think they could find other sources to do that.' She has carried the bill before and is part of a bipartisan coalition of lawmakers that have pleaded its case in the legislature. 'I think it's time for us to try something new, and I've been really happy to support this,' said Del. Ellen Campbell, R-Rockbridge, a key co-patron of the bill. But the proposal has faced opposition from the Pharmaceutical Research and Manufacturers of America. The prominent trade group has lobbied against the bill and expressed skepticism about its potential effectiveness if such a board were established. Charise Richard, a senior director of state policy at PhRMA, stressed that PDABs are relatively untested, despite their surge in recent years. While at least 11 states have implemented the boards, Maryland was the nation's first. Created in 2019, opponents have pointed to how it was slow to be set up and has not yet yielded the amount of cost-savings at the core of its mission. Last fall, the board approved a process to set an upper limit payment to cap drug costs on state health plans. And an effort this year to expand the board resulted in heated debate in Maryland's legislature. PhRMA also highlights that patients with rare diseases, who rely on specialty drugs that can come with higher price tags than more common drugs, have expressed concerns about PDABs' potential to hinder, not help, them. While in opposition to PDABs, the organization is supportive of other proposals aimed at reducing skyrocketing prescription costs. Richard noted a recent Federal Trade Commission report showing how Pharmacy Benefit Managers are up-charging cancer, HIV and other specialty drugs as evidence that PBM reform is needed. PBMs act as intermediaries between health plans, drug manufacturers and pharmacies, but their lack of transparency has raised concerns. PBMs retain rebates and discounts from contracts, leaving consumers and pharmacies unsure how much savings are being passed on. This opacity has taken a toll on local pharmacies, which often receive reimbursement rates lower than the cost of medications. 'It's been a long time coming that PBMs need to be held accountable,' Richard said. A bipartisan effort for Virginia to have a single state-monitored PBM also cleared the legislature this session and is likewise awaiting action from the governor. Local and chain pharmacists flocked to the Capitol from around Virginia in recent months to speak in support of that bill. Richard called the bill a 'small but mighty step' towards PBM reform and said that her organization has also pressed for PBM's compensation to be 'de-linked' from the list price of medicines. March 24 is the deadline for Youngkin to take action on hundreds of bills that were sent to him this year. Though the PDAB proposal could garner another veto from him, it remains unseen how the PBM bill will fare. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
21-03-2025
- Health
- Yahoo
Why the PDAB bill deserves Gov. Youngkin's veto
(Photo by) As a father, I am deeply concerned about my daughter Angelica's future if Virginia enacts HB 1724, a bill that would create a Prescription Drug Affordability Board to set limits on the costs of certain medications. Angelica has Prader-Willi Syndrome (PWS), a rare genetic disorder that impacts her growth, hunger, and overall development. Managing her condition requires access to specialized medications, including growth hormone — the only approved treatment for PWS. If Virginia's Prescription Drug Affordability Board (PDAB) sets upper payment limits on newer therapies, it could make it harder for families like mine to access life-changing treatments, creating barriers to care rather than improving affordability. My wife and I were thrilled to be expecting after three years of marriage. Early genetic testing at 20 weeks revealed that our daughter had PWS, a devastating diagnosis. At birth, she had low muscle tone, couldn't eat on her own and barely cried. After 21 days in the NICU, she came home requiring constant monitoring. She has since been diagnosed with Autism and Scoliosis and relies on daily therapies to progress. Despite her challenges, my daughter has made remarkable strides. She can now walk, run, jump, kick a ball, talk and eat independently. However, she still struggles with routine changes and is beginning to show an increased interest in food — a potential sign of hyperphagia, the relentless hunger that is the hallmark of PWS. Without access to growth hormone and other specialized medications, her quality of life and future independence could be in jeopardy. Another major concern with HB 1724 is the potential use of Quality-Adjusted Life Years (QALYs) in determining drug value. QALYs assign a numerical value to a person's life based on their health status, often disadvantageous to individuals with disabilities or chronic conditions by devaluing treatments that improve their quality of life rather than curing their condition. If the PDAB relies on QALYs to set upper payment limits, rare disease patients like my daughter could face significant barriers to accessing essential medications. History shows that PDABs fail to deliver on their promises. In 2019, Maryland passed a PDAB, yet it has not saved a single patient any money. If this model hasn't worked there, why would we expect it to work in Virginia? Instead of reducing costs, price controls create uncertainty in the drug supply and discourage innovation. HB 1724 does nothing to address the root causes of high drug prices and could leave some of the most vulnerable Virginians without the medications they need to survive. There are better solutions for Virginians. Instead of imposing price caps that could drive critical drugs out of Virginia, lawmakers should focus on policies that protect access to life-saving medications while also addressing affordability concerns. I urge Gov. Youngkin to once again veto the PDAB legislation. My daughter's life — and the lives of many others with rare diseases — depend on it. Virginia families should not have to worry about whether their loved ones will have access to the medications they need to thrive. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
