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Lawmakers and advocates urge governor to sign prescription drug affordability board bill • Virginia Mercury

Virginia lawmakers and community advocates are urging Gov. Glenn Youngkin to sign a bill into law creating a state prescription drug affordability board in an effort to lower medication prices. 

Speaking in support of the legislation at Diversity Richmond, Sen. Schuyler VanValkenburg, D-Henrico and Del. Destiny LeVere Bolling, D-Henrico, said every day their constituents tell them they have to make “impossible” choices between their basic necessities and the health care they need.

Richmond resident Savannah Morris has Crohn’s Disease and said she’s had to start skipping her medication because she cannot pay for it. 

“Between paying the debt from my surgeries, college tuition, school fees, supplies for my ileostomy bag and medications related to my mental health — I’ve had to make hard decisions about what I can and can’t afford,” Morris said. 

Identical bills from Sen. Creigh Deeds, D-Charlottesville, and Del. Karrie Delaney, D-Fairfax, would establish the prescription drug affordability board — an independent body composed of health and medical experts who would use proven, data-based strategies to set upper payment limits on medications. The bills passed their respective chambers with bipartisan support coming primarily from the Senate and were included in the legislature’s budget, released in February.

Amendments establishing single Va. Medicaid pharmacy benefits manager die in conference

A 2023 poll from AARP found three-quarters of Virginia voters want their legislators to pass measures to create a PDAB, including 85% of Democrats, 71% of Republicans and 70% of Independents.

Bolling noted that multinational pharmaceutical companies and manufacturers continue to reach record profits year after year, which is why the proposal would help “level the playing field” for Virginians.

While similar boards have been established across eight states, Colorado’s is the only one that has moved forward with considering price limits on two prescriptions since its launch in 2021. Despite declaring cystic fibrosis drug Trikafta unaffordable last December, the board voted against setting a price cap, according to the Colorado Sun.

When asked if a similar situation could happen in Virginia, Freedom Virginia Executive Director Rhena Hicks pointed out that Colorado’s PDAB did its job by reviewing Trikata’s affordability. The board declined to cap its price primarily because the drug’s manufacturer provides a large assistance program and patients weren’t struggling to afford it in the state, Hicks said, a sentiment echoed by Colorado’s PDAB chair Dr. Gail Mizner.

VanValkenburg also said it’s important to know the PDAB programs are new and, like a lot of emerging policies, are not a one-step process. 

“The important part about getting this bill into law is that we can start propping it up and then we can start refining it as we need to,” he said. 

Colorado is also being sued by pharmaceutical company Amgen over the state board’s efforts to possibly cap the price of arthritis drug Enbrel. When asked if Virginia is prepared to face similar lawsuits if a PDAB is established in the commonwealth, VanValkenburg said pharmaceutical companies can flood the state with lawsuits, but it’s a waste of their time.

“Baseless lawsuits get filed all the time in court and that shouldn’t be a reason why we do anything,” he said. 

The PDAB legislation is also complemented by identical bills from Del. Atoosa Reaser, D-Loudoun and Sen. Jennifer Carroll Foy, D-Prince William, which would require increased reporting transparency from pharmacy benefits managers — the middlemen who negotiate contracts between health plans, drug manufacturers and pharmacies — to ensure savings from rebates or discounts are going back to Virginians. Youngkin signed the bills into law this month.

However, those reports would be inaccessible to the public. If the state establishes a PDAB, Reaser’s Chief of Staff Caleigh Lynch said it would have access to the reports, therefore expanding transparency by giving the state government more information about the cost of a drug.

“This is just the beginning of increasing the transparency in these reports,” Lynch said. “In the future, we hope to make more information publicly available.”

Additionally, independent pharmacists say they’re still concerned Virginia might not see full transparency from PBMs — the majority of whom are controlled by three companies — and instead supported budget amendments to contract a single company to work with the state Medicaid program. That amendment died in conference this February. 

Youngkin has until April 8 to sign the prescription drug affordability board legislation.

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