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How much is too much?
Maryland鈥檚 Prescription Drug Affordability Board sharpened its focus Monday on establishing a process to impose upper price limits for some prescription drugs in the state.
Maryland, a聽聽for medications, has no definition for 鈥渦pper payment limits鈥� within its state code.
鈥淪o for our purposes, it means the maximum amount paid or reimbursed for a prescription drug product,鈥� said Andrew York, the executive director for the Prescription Drug Affordability Board,
Michele J. McDonald, general counsel from the Maryland Attorney General鈥檚 Office, said that this gives the board the flexibility to set its own limit.
York, who presented a report to board members Monday, said the board would also be responsible for selecting which drugs the limit would apply to.
鈥淎ll of that needs to be fleshed out,鈥� he said.
鲍苍诲别谤听聽that created the council, the Prescription Drug Affordability Board was tasked with studying upper payment limits 鈥� and given the authority to draft plans of action in partnership with a Stakeholder Council to set upper payment limits on prescription drugs.
Plans of action must be approved by the General Assembly鈥檚 Legislative Policy Committee or the governor and attorney general within 45 days of presentment.
Under the initial policy, the Prescription Drug Affordability Board would have been able to set upper payment limits on drugs purchased by state and local governments 鈥� including universities, hospitals and correctional centers 鈥� on behalf of state and local government employees, or through the Maryland State Medical Assistance Program on Jan. 1, 2022.
However, Gov. Lawrence J. Hogan Jr. (R)聽聽meant to establish the board鈥檚 funding mechanism,聽.
During an interview after Monday鈥檚 hearing, Vincent C. DeMarco, the head of the Maryland Citizens鈥� Health Initiative, said that he is 鈥渢hrilled鈥� the board is making headway on imposing upper payment limits, adding that he knows each member is aware 鈥渢hat drugs don鈥檛 work if people can鈥檛 afford them.鈥�
According to the Department of Budget and Management, Maryland state employees spent roughly $390 million on prescription drugs in 2020.
York laid out the benefits of having caps on prescription drug costs, including savings for taxpayers, reduced out-of-pocket spending and expanded access to care. On the other hand, it could cause certain drug manufacturers to choose not to sell their products in the state, causing access issues.
鈥淚 think the access issue is something that we have to be concerned about, but in reality, Maryland state employees are a very small portion of this market,鈥� said Dr. Gerard Anderson, a member of the board. 鈥淪o you know, the major drug companies 鈥� are not going to, therefore, pull out unless they want to make it as a show.鈥�
In order to expand the upper payment limit to all Marylanders, the Prescription Drug Affordability Board will have to turn to the General Assembly to take up the matter legislatively.
鈥淎s early as 2023, that鈥檚 going to be expanded to the entire state by the legislature but 鈥� for now, our current scope is for state and local governments,鈥� York said.
He also recommended expanding a policy passed during the 2022 legislative session to聽聽for patients with health insurance to the uninsured.
York鈥檚 final report detailing the board鈥檚 recommended policy priorities is due on June 30.
