State Affordability Boards Taking On Drug Makers Where The Feds Have Failed
Frustrated by high drug prices and inadequate policy changes at the federal level (save for slow-moving Medicare drug price negotiations), states are setting up drug affordability boards that can have vast powers to reduce drug costs. This includes setting an upper limit for sales in their state for certain coverage and the uninsured. This is similar to the Medicare drug price negotiations.
Due to federal pre-emption, these boards only apply to commercial plans. Medicaid has a federal rebate law that allows for federal and state rebates. Medicare is not covered as private plans negotiate prices with drug makers through pharmacy benefits managers or directly. Under the self-insured employer ERISA law, employer groups appear to be able to opt in and thus this has been built into some state laws.
So far, eleven states have approved establishing drug affordability boards, and about a dozen more are considering doing so. Drug makers are suing, claiming the boards are unconstitutional and override several federal laws and due process.
#drugpricing #ira #branddrugmakers #employercoverage #erisa
