Aiming to protect residents and the state’s healthcare system from exorbitant prescription drug costs, the Maryland Price Drug Affordability Board (PDAB) met this week to consider conducting an affordability review on eight prescription drugs.
“Right now what we’re talking about is identifying drugs to consider for cost review, and then potentially referring those drugs (and) products to the stakeholder council,” said Andrew York, executive director of PDAB. “This is the start of … A pretty intensive process.”
The board consists of five members with expertise in healthcare economics or clinical medicine. PDAB is considering conducting an affordability review for Biktarvy. Biktarvy is an antiretroviral combination medication that is one of the top 100 prescription drug products with the highest total out-of-pocket costs for patients, according to PDAB. Other drugs on PDAB’s list include:
- Dupixent, which is used to prevent severe asthma attacks, has a list-price of $3,803 per carton.
- Farxiga, which reduces the amount of glucose in an individual’s blood urine to assist with kidney function, has a list price of $582 for a 30-day supply.
- Jardiance, which is used to improve blood glucose levels in individuals living with Type 2 diabetes, has a list price of $570 for a 30-day supply.
- Ozempic, which is also used to improve blood glucose levels in individuals living with Type 2 diabetes, has a list price of $936 per injectable pen.
- Skyrizi, which is used to treat patients living with psoriasis and moderate-to-severe Crohn’s disease, has a list price of $21,017 per dose.
- Trulicity, which is used to assist Type 2 diabetics with releasing natural insulin, has a list price of $977 per month.
- Vyvanse, a central nervous system stimulant used to treat attention deficit hyperactivity disorder, costs about $460 per 30-day supply.
“These drugs, for the most part, are among the most wildly popular drugs … Treating the most patients in the state,” said PDAB member Stephen Rockower, who added that setting upper payment limits, even by small amounts, could create significant savings for patients and the state.
Gerard Anderson, PDAB member, said one of the most important variables in selecting drugs for upper payment limits is out-of-pocket spending.
“I looked at (out of pocket spending)both at the person level and at the aggregate level. I think the people of Maryland will notice if we [Maryland residents] have to pay less,” Anderson said.
Anderson said high out-of-pocket costs for prescription medications often deter patients from taking a drug.
“Access would improve, especially for the most vulnerable (and) for the most low-income individuals,” Anderson said.
While certain manufacturers, like Novo Nordisk—which makes Ozempic—have patient assistance programs and offer coupons for select patients, those aren’t long-term solutions, and can create barriers as well.
“[Programs and coupons] are at the discretion of the drug company, and the patient assistance companies that offer them.”
— Anderson
PDAB is tracking about 38 bills in the legislature—excluding those that have been cross-filed—that are related to the board’s work. The board is also working on launching a new website, which is expected to go live the second week of April. The board encourages active engagement from members of the public.
“It would be great to hear from people in the public about what other drugs could be added to the list, and why,” Anderson added.
The Board will meet again on May 20.