The Colorado Prescription Drug Affordability Board (PDAB) announced dates for public meetings to be held for the five drugs it may consider for upper payment limits (UPLs) during its meeting on Friday. PDAB will consider the affordability of Enbrel, Genvoya, Cosentyx, Stelara, and Trikafta, and could consider recommending the drugs for UPLs. PDAB Director Lila … Read more

A new audit on Oregon pharmacy benefit managers (PBMs) recommends that the state enact legislation that focuses on patient and pharmacy protections, and increases transparency in the prescription drug supply chain.     The state released the audit on Monday, which examines PBM business practices in the state. PBMs were established in the 1960s to … Read more

While some state programs are helping curb the soaring costs of prescription drugs in Michigan, there is still work to be done. Industry leaders discussed those efforts at the 2023 Michigan State of Reform Health Policy Conference.     The US healthcare system spent $603 billion on prescription drugs in 2021. Elizabeth Kutter, senior director … Read more

After becoming the first state to establish a Prescription Drug Affordability Board (PDAB) in 2019, Maryland is set to draft and publish a plan of action for setting upper payment limits on prescription drugs by May 15th.  On April 11th, Gov. Wes Moore signed House Bill 279 into law, which re-establishes PDAB’s authority to set … Read more

Pharmacy benefit manager (PBM) business practices are hindering pharmacists’ abilities to provide needed medications for Floridians, according to Dr. Kevin Duane, owner of Panama Pharmacy in Jacksonville.  Duane is one of many pharmacy owners who have testified in support of Senate Bill 1550, which aims to save Floridians money on prescription drugs by regulating PBMs. … Read more

The Colorado House Health and Insurance Committee unanimously passed House Bill 1183, an amendment to the state’s Medicaid protocols for step therapy, on Tuesday.      Step therapy is a prior authorization protocol that requires patients try at least one medication selected by their insurer before the plan will grant coverage for the drug originally … Read more

Maryland lawmakers, like their federal counterparts, are focused on addressing the growing cost of prescription drugs. One approach that is being recognized at the state level is the establishment of Prescription Drug Affordability Boards (PDAB).     PDABs are independent bodies empowered to analyze the high cost of drugs, impose upper payment limits, or suggest … Read more

President Biden signed a sweeping $750 billion health care, tax, and climate bill on Tuesday. The move comes after Congress passed the Inflation Reduction Act last week through reconciliation, with vote counts of 220-207 in the House and 51-50 in the Senate—an even split along party lines that was decided by Vice President Kamala Harris’s … Read more

My name is Eli Kirshbaum and I’m a Senior Reporter/Editor here at State of Reform. Emily is out on vacation for the next two weeks, so I’m stepping in to write her newsletters while she’s gone. Please feel free to reach out to me if you have any questions or comments during her time off—I’d be happy … Read more

This month’s newsletter includes data on Medicaid beneficiaries’ ED utilization, insight on how federal legislation to lower Medicare Part D prescription drug prices would benefit Coloradans, and more. Thanks for reading! Eli Kirshbaum  State of Reform   1. Report shows Coloradans would benefit from Medicare Rx cost reform A new report from the Kaiser Family Foundation says over … Read more