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Digging Deep: PDABs

Writer's picture: PUTTPUTT

Author: Brandi Chane, PUTT Executive Board member


In the Fall of 2024 we had the opportunity to attend the PDAB Patient Advocacy Summit in DC where we learned of a concerning initiative that everyone would benefit from keeping on their radar.


Prescription Drug Affordability Boards (PDABs) are state-level regulatory bodies created to address prescription medication costs. Their main goals are to ensure prescription drugs are affordable for residents and to curb excessive drug price increases - unfortunately, their actions can cause more harm than good when it comes to pharmacies and their patients.


As of July 1, 2024 there are eleven states that have enacted Prescription Drug Affordability Boards: Colorado, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Ohio, Oregon, and Washington.


Who do these boards actually benefit, and why do they seem to be the brainchild of PBMs?

When we discovered the ramifications of PDABs, we were shocked. Much like the Inflation Reduction Act (IRA), PDABs set the state’s upper payment limits (UPLs) - many times with rates that are below actual acquisition cost, and unbeknownst to pharmacies until a patient arrives at the pharmacy counter. These state level UPLs can introduce more administrative burdens on pharmacies from additional pricing regulations, and can have the effect of limiting the availability of brand medications, that for some patients, are clinically necessary.

In theory, PDABs can sound like a positive thing. In reality, without input from pharmacists on the front lines, PDABs have the potential to become a giant wrecking ball aimed directly at independent pharmacies and patient care. 


We've reviewed current legislation and the question remains - how will pharmacies purchase PDAB regulated drugs, and who will make them whole when they aren’t able to acquire those drugs under the enacted UPL? Saving money in complex disease states is important, but will pharmacies carry the financial burden while patients pay the ultimate price in compromised care? What happens when a patient can no longer access their pharmacy of choice? It appears PDAB board members making these decisions don’t comprehend the unintended consequences that may arise from their actions.


As pharmacists, our proactive involvement in this area is essential. We must get involved to ensure that PDABs operate with transparency, and in a way that benefits both patients and healthcare providers.


For a copy of an informational sheet on PDABs click here

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