Angry Patients Spur New State Watchdogs to Lower Drug Prices

Frustrated with high prescription drug costs, states are creating public boards to regulate pricing and make medications more affordable. These boards, similar to local utility boards, aim to ensure that prescription drugs are accessible to everyone.

State Boards and Their Roles

Some states have given these watchdogs the power to regulate drug prices for specific groups, such as state employees or Medicaid recipients. A few states, like Colorado, Minnesota, and Washington, have empowered their boards to oversee drug prices for all residents. Over the past five years, 11 states, mostly led by Democrats, have created prescription drug affordability boards, with more states considering similar legislation.

Functions and Challenges

These boards identify unaffordable medications, suggest ways for state health plans or Medicaid programs to reduce drug spending, and sometimes cap the amount insurers pay for prescriptions. However, progress has been slow due to administrative and funding challenges. For instance, Maryland’s board has faced delays but is now focusing on reviewing the costs of six drugs, including diabetes and asthma medications.

Consumer Impact

Many Americans struggle with high drug costs, with some having to choose between paying for rent or medications. Prescription drugs in the U.S. are more expensive than in other high-income countries, and price increases often outpace inflation. Nearly 30% of people surveyed by KFF in 2023 reported not taking their medications as prescribed due to cost.

Political and Industry Pushback

Most states with these boards are Democratic-controlled, but some Republican-led states are also considering similar measures. Despite bipartisan support, these boards face resistance from the pharmaceutical industry and patient advocacy groups worried about access to medications. For example, Colorado’s board declared the arthritis drug Enbrel unaffordable, prompting a lawsuit from the manufacturer, Amgen.

Future Directions

State boards vary in their authority and methods, with some having the power to cap drug prices for all consumers. For example, Minnesota’s board, established last year, is one of the few with such extensive powers. Maryland’s board, created in 2019, is working on initiatives like an insulin affordability program to help patients access lower-priced insulin.

State prescription drug affordability boards aim to reduce drug costs and make medications more accessible. While they face challenges and pushback, these boards are exploring ways to help more patients afford their medications, potentially setting a precedent for future national policies.

References

• Kobe University
• BMJ Open Sport & Exercise Medicine