Virginia and Hawaii Introduce PDAB Legislation

The Virginia Senate introduced a bill to establish a Prescription Drug Affordability Board (PDAB) to review drugs with a wholesale acquisition cost (WAC) of $60,000 or more per year or a WAC increase of $3,000 or more in any 12-month period. For drugs deemed to cause an affordability challenge, the legislation authorizes the PDAB to establish upper payment limits (UPLs) that would apply to all purchases and reimbursements with the ability for ERISA plans to opt in. For drugs with Medicare-Negotiated MFPs, the UPL is directed to match MFP. Former Gov. Glenn Youngkin (R) vetoed similar bills in the past two legislative sessions.

Similarly, lawmakers in Hawaii introduced legislation to establish a PDAB tasked with reviewing drugs with a WAC of $30,000 or more per year or WAC increases of more than 15% within a year or 40% over a three-year period. The PDAB would have UPL authority and would utilize Medicare reference pricing or the MFP when applicable. The bill also establishes copay caps for insulin at $35, inhalers at $50, and epi-pens at $60, with a prohibition on copay adjustment programs.