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Maryland at the Forefront of Groundbreaking Legislation to Lower Drug Prices

The State Legislature has created a Prescription Drug Affordability Board, an independent body that will review and cap the costs of certain prescription drugs when purchased by state and local government employers.

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Before there was a generic available, it cost Suzanne Schlattman $1,200 per year to carry the life-saving EpiPen to protect her 5-year old son from potential life-threatening complications.

The first time she filled the prescription three years ago, she paid $150 for a set, which is sold in a pack of two. Since then, the price has increased to $600 per set, and because EpiPens have a shorter shelf life than most drugs (requiring replacement every 20 months), the burden on her family is large.

“The cost of EpiPens is out of control, and it’s not fair. Each year, the price has more than doubled, which is not sustainable for my family,” Schlattman said. “There has got to be a better way to address rising drug costs.”

EpiPens have experienced an outrageous 450% price hike between 2004 and 2016 — but such unjustifiable price hikes for various drugs are all too common, with millions of Americans choosing to forego treatment due to rising costs.

450%

Increase in price of EpiPens from 2004-2016

Take the Parkinson’s disease patient from Maryland, Stahis Panagides, who was recently prescribed Rytary, a drug that costs $400 a month despite his Medicare coverage. “It’s heartbreaking to know that there’s a drug out there that could treat my symptoms, but I can’t access it because the price is just too high,” Stahis told Patients for Affordable Drugs Now.

Lowering prices for consumers at the pharmacy counter will require comprehensive action. While there isn’t a single solution, Maryland is now one step closer to addressing high prescription drug prices. On Monday, the Maryland Legislature voted to create a Prescription Drug Affordability Board with the authority to review drug costs and set reasonable payment rates for drugs — similar to a state’s approach to regulate utilities.

The Maryland Prescription Drug Affordability Board would be the first of its kind, acting as an independent body to set limits on how much state and local governments pay for expensive drugs. The goal, according to state officials, is to lower prescription drug spending in the state.

What the Prescription Drug Affordability Board Can Do

The five-member commission would have the authority to review:

  • Brand-name drugs that launch at $30,000 or more a year or per course of treatment
  • Existing brand-name drugs with price hikes of at least $3,000 per year or during the course of treatment
  • Biosimilars that launch at less than a 15% discount to their reference brand biologic
  • Generics priced over $100 for a 30-day supply or course of treatment with price hikes of 200% or more
  • Any drugs that may pose affordability challenges for health systems or patients

Though originally proposed to cover all Marylanders, the bill has been scaled back, giving the board the authority to limit only what the state will pay for certain prescription drugs purchased by state and local governments on behalf of state hospitals, county correctional facilities, and health clinics at state institutions. The board must report to the General Assembly in 2023 with recommendations on whether the board’s authority to set upper payment limits should be expanded statewide to all purchases of high-cost drugs. The legislation is an important step forward in addressing the unaffordable price of prescription drugs in Maryland.

This progress comes at a time when many states are focused on reining in prescription drug costs. Several other states, including Massachusetts and Minnesota, are considering legislation to create a prescription drug affordability board.

Maryland Gov. Larry Hogan has until May 31, 2019, to sign or veto the bill. If the bill is signed into law, the measure will take effect on July 1, 2019.