In 2019, amid big promises, state lawmakers launched an effort to lower drug prices through the creation of a Prescription Drug Affordability Council.
By creating an entity with a mandate to provide relief to consumers, lawmakers boasted, they were making Maryland the first state to tackle the pharmaceutical industry head-on. (Something Congress, with its penchant for Big Pharma campaign contributions, has refused to do.)
Nearly three years later, the board’s original mandate remains narrow — figure out which drugs cost too much, then put in place a legally defensible method to cap how much state and local government health plans can be forced to pay. to provide these drugs to their employees.
The Commission’s work to date has yet to benefit consumers or taxpayers. The panel, known by its acronym, PDAB, has become bogged down in administrative tasks, such as finding a way to fund its work and hiring an executive director.
Despite the slow start, chairman of the board, former state Del. Van Mitchell, said the panel was generating momentum. A funding source has been identified, an executive director has been hired, and a “stakeholder council” is in place to provide community and industry feedback.
Mitchell said he expects the coming months will bring a series of recommendations on how to bring down sky-high drug prices. “We are getting there. We get organized. We are ready to present good things in the next 90 days…” he said in an interview.
The pharmaceutical lobby has fought the creation of the Maryland Affordability Council, and it has strengthened its presence in states that are making similar noises. Any cost-cutting or containment programs Maryland adopts are likely to face legal challenges from industry, Mitchell conceded. “Interfering with the market is a real concern for a lot of people, and it should be,” he said.
“I’m not looking for a quick win,” he added. “I want to find things that are sustainable and make good politics and common sense, not just a headline.”
Vincent DeMarco, head of Maryland Healthcare for All, an advocacy organization, expressed optimism that any price reduction mechanism the council engages in will survive scrutiny. “States do this all the time,” he said. “They do this with utilities. States do this to such an extent that they are involved in protecting their citizens against all kinds of acts.
The national campaign to reduce the cost of prescription drugs received a huge boost when Congress passed and President Biden signed the Cut Inflation Act, a measure that, among other things, will allow Medicare to use its purchasing power to negotiate lower drug prices. Democrats and consumer advocates have fought for such action for decades.
The IRA also caps monthly insulin costs for Medicare beneficiaries and requires drug companies to pay rebates if drug prices rise faster than inflation.
Under the law that created the Maryland Prescription Drug Board, the committee must provide recommendations next year on how to make drugs more affordable for all Marylanders — not just those covered by plans. state and local government health services.
Beginning this week, Maryland residents will have the opportunity to tell the council how they have been affected by drug costs. The Maryland Health Care for All Coalition and AARP Maryland are sponsoring a series of forums to be held across the state; a statewide virtual forum is scheduled for Tuesday evening.
“This is a key moment for the board as it begins to implement programs aimed at reducing drug costs,” said Jim Gutman, an AARP Maryland leader and stakeholder council member, in a press release. “The specific details of the audience at these forum sessions will be extremely valuable in this regard.”
In addition to its slow start to fund operations and hire staff, Mitchell said the council struggled to get data on drug prices. Such data is essential for the panel if it is to ask legislative leaders to declare a subset of drugs “overpriced.”
“It’s been a problem,” he said. “It’s hard to find data that isn’t two years old.”
Mitchell and the accessibility council’s new executive director, Andrew York, a former research analyst with the federal Centers for Medicare & Medicaid Services, meet regularly with leaders from other states. There was talk of pooling resources to put together good numbers.
“We’ll never have $1 million to buy data every year,” he said. “That’s just not how we’re organized.”