As Virginia lawmakers debate legislation to create a prescription drug affordability board, similar policies in other states are already facing legal challenges that could shape how such programs are implemented nationwide.
Virginia’s proposal, Senate Bill 271, would establish a Prescription Drug Affordability Board (PDAB) empowered to review certain high-cost medicines and impose “upper payment limits” on what insurers and other purchasers pay for those drugs.
But states that have adopted similar policies have encountered legal and practical obstacles.
A policy analysis released this week by MultiState Associates noted that legal challenges are emerging as states begin implementing drug price caps through prescription drug affordability boards.
In Colorado, courts are considering a legal challenge to the state’s authority to impose payment limits on a drug. According to the analysis, the lawsuit argues that state-imposed price caps could conflict with federal law and violate constitutional protections.
“State drug pricing policy through PDABs faces legal challenges in Colorado,” wrote Mary Kate Barnauskas, senior associate at MultiState Associates, noting the lawsuit claims the policy attempts to regulate economic activity beyond the state’s authority.
Several states have adopted drug affordability boards in recent years as lawmakers search for ways to address rising prescription drug costs.
Colorado, Maryland, Washington, Oregon, Minnesota and New Hampshire have enacted versions of the policy, though their authority to impose payment limits varies by state.
Some states have already begun testing the limits of those powers.
The analysis said legal disputes could determine how aggressively states can regulate drug pricing in the future.
“Legal challenges continue to shape the PDAB landscape,” the MultiState report noted, as courts evaluate whether state-imposed payment limits conflict with federal law or constitutional protections.
Terry Wilcox, co-founder of patient advocacy group, Patients Rising, referenced the PDAB implementation challenges in other states in her group’s opposition to the Virginia proposal.
“Patients should be the ones driving the conversation about their healthcare, not bureaucratic boards that have failed to deliver results in every state that has tried them,” said Wilcox in a post on the group’s website. “Virginia families deserve better than a costly experiment that puts access to their medications at risk.”
Wilcox said the boards in those other states have not produced measurable savings for patients in states where they have been implemented.
