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The Danger of PDABs

Patients and their trusted health care providers should always have full control over treatment decisions – but insurance companies, pharmacy benefit managers (PBMs), and third-party vendors frequently interfere. These obstacles include a burgeoning threat in states around the country: the emergence of Prescription Drug Affordability Boards (PDABs).

PDAB Conflicts and Consequences

While the term “affordability” might initially sound
promising, these state-run drug boards do not actually
make medications affordable for the people who need
them most: patients. Out-of-pocket costs and
access to treatment are top priorities for patients,

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but the unelected political appointees running PDABs have free rein to set price controls on
life-saving medicines. Putting the power in political appointees’ hands could have life-threatening consequences as states interfere with patients’ ability to make personal treatment decisions with their health care professionals. Pharmacists have already told the drug boards that price controls could cause them to stop supplying the targeted drugs, leaving patients without access to the medicines they depend on to live.

The good news: Some states have recognized the fundamental issue with PDABs. In April 2024, Virginia Gov. Glenn Youngkin
vetoed HB570 and SB274, which would have established a PDAB and enacted price controls on prescription medicines. Without question, a PDAB would have limited Virginia patients’ access to prescription drugs solely based on pricing – not expert advice from medical professionals related to the unique needs of individual patients.


Colorado’s Harmful Limits

Troubling developments with Colorado’s PDAB underscore the restrictive, harmful nature of these boards. Colorado’s PDAB voted in February 2024 to enact the nation’s first upper payment limit (UPL) policy – the maximum price the state government will pay for a drug. Declaring medicines “unaffordable” leads to consequences that include restricted access and higher out-of-pocket costs, and Colorado’s misguided intervention is setting an alarming precedent.

Through the UPL process, Colorado’s political appointees have not addressed how third-party interference from insurance companies and PBMs have directly distorted the drug’s price for patients, nor have they truly valued patients’ perspectives. Many patients and their caregivers have expressed fears about price limits further hindering accessibility and affordability, yet PDABs typically only consider feedback from a select few, limiting direct public commentary that may run counter to their policies.

Stand Against PDABs

It’s time for decision makers to do what’s right. Political appointees should not have a say in the treatments patients and their doctors decide are best.

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