In response to rising prescription drug costs and their impact on healthcare spending, some states have established prescription drug affordability boards (PDABs) to review certain high-cost prescription drugs and determine whether states should take action to reduce those costs. 

• The intended function of these government bodies is to reduce the price of prescription drugs to the government and commercial market in a state.

• Many examples of drug affordability offered by proponents of PDAB focus on benefit design, not the price of a prescription medicine

• To date, PDABs remain experimental.  With the first PDAB passed in 2019, to-date, no PDAB has lowered the cost of any medicines, or reduced patient costs.

• Upper payment limits (UPL) imposed by a PDAB on a therapeutic are only applicable in that state, even though the product may enter commerce in another state at a higher price, leaving patients to make up the difference between the acquisition cost and the UPL permitted in that state.

Any PDAB decision that harms patient access to a rare therapy is unacceptable. PDABs have the potential to disrupt current and future access to rare therapies. RAAP urges lawmakers to consider solutions to patient access that can lower out of pocket costs and encourage benefit design that doesn’t rely on plans pushing therapy access out of reach to some patients.