#USA #Virginia #Rare Access Action Project #Prescription Drug Affordability #Virginia Politics

Virginia Legislators Urged to Rethink Prescription Drug Affordability Board Measures

In a striking plea, the Rare Access Action Project (RAAP) has called on Virginia legislators to abandon their push for the implementation of Prescription Drug Affordability Boards (PDABs), citing extensive evidence that such measures have repeatedly failed across numerous states. As the debate continues, the RAAP highlights the real impact of these policies on patient accessibility to life-saving medications.

The core of the argument against PDABs centers on their proven ineffectiveness. The RAAP recently released a report titled "Solving for Access and Affordability PDABs are Not the Answer," showcasing a disheartening trend: states that have adopted PDABs, such as New Hampshire and Oregon, have either repealed them or recommended their discontinuation due to recognized pitfalls including inflated costs and unfounded savings claims.

What Are PDABs?

PDABs are designed to create payment limits for prescription drugs, ostensibly aiming to keep costs predictable for insurers and patients. However, the RAAP asserts that these limits only address the price insurers will pay, not the actual acquisition costs that pharmacies and healthcare providers bear. Consequently, this disconnect could lead to significant access challenges for patients requiring specialized treatments—especially those facing complex medical needs.

Michael Eging, the Executive Director of RAAP, emphasized the organization's longstanding concerns regarding the potential adverse outcomes of these boards on patients suffering from rare diseases and their healthcare providers. He stated, "PDABs are not only an ineffective tool for controlling costs but also expose systemic flaws that inhibit patient access to necessary treatments."

Concrete Examples of Failure

Across the nation, numerous cases illustrate how PDABs have faltered:

• - New Hampshire: The state repealed its PDAB in 2025 after realizing the projected savings did not justify the costs incurred.
• - Oregon: Recommendations from the PDAB’s vice chair in 2025 called for termination due to excessive expenditures.
• - Maryland: Board members expressed skepticism regarding the efficacy of Upper Payment Limits (UPL) in producing savings.
• - Colorado, Maine, and others: Collectively report no financial relief for patients from PDAB initiatives.

The RAAP warns that similar results could easily emerge in Virginia if lawmakers push ahead with the PDAB proposal without careful consideration of evidence from other states.

Alternative Solutions

In light of the apparent ineffectiveness of PDABs, RAAP along with other advocacy groups have proposed several viable alternatives aimed at genuinely reducing prescription drug costs while maintaining accessibility:

• - Capped Out-of-Pocket Schemes: Implementing alternatives in the insurance marketplace that cap out-of-pocket costs for patients.
• - Expanded Medicare Access: Broadening Medicare Part B access for individuals below the age of 65, ensuring that younger patients receive the necessary support.
• - Pharmacy Benefit Manager Reforms: Modifying the structural mandates of PBMs so they can more transparently share rebates with patients and avoid inflated costs.
• - Public/Private Risk Pools: Establishing risk pools for high-cost patients to stabilize funding and delivery of care.

Eging urged Virginia lawmakers to take a moment to consider these alternatives carefully. "It is crucial we pause discussions surrounding the PDAB bill to study the long-term implications it brings to cost and patient access," he remarked.

In closing, the RAAP emphasizes that the path to successfully managing prescription drug costs requires thoughtful dialogue with stakeholders, especially those directly affected by rare diseases and high medical costs. The overarching call is for legislators to step back from politically charged discussions and redirect their efforts toward solutions that prioritize patient welfare.

Conclusion

The debate surrounding the implementation of PDABs in Virginia signifies a critical juncture in healthcare policy. A collective effort focusing on effective and sustainable solutions is essential to safeguard patient access to necessary treatments. As legislators weigh their options, the voices of advocacy groups like RAAP highlight the need for informed policy-making that genuinely benefits individuals facing complex medical challenges.