Virginians could pay less for prescription drugs under this Democratic bill

Virginia Democrats are advancing a bill to lower the cost of prescription drugs. 

House Bill (HB) 570 from Delegate Karrie K. Delaney (D-Fairfax) would establish a Prescription Drug Affordability Board, which would be responsible for protecting Virginians from the high costs of prescription drug products. 

If passed, the bill will direct the governor to appoint the members of the board, as well as alternate members; the board would be made up of a “small, independent group of health care experts.” 

The group would meet four times per year in open session and would be tasked with identifying prescription, generic, and other drugs, as defined in the bill, that are offered for sale in the state and conduct an “affordability review” of those products. 

The bill lists a large number of factors that the board would consider during these reviews, such as considering the price of biosimilar drugs, which are drugs that are biologically the same as name brands, but usually cheaper. The board would then use these factors to analyze the affordability of certain high-priced prescription drugs and then institute price limits to protect consumers from price-gouging.

The board would report their findings to the General Assembly twice yearly. Decisions made during these affordability reviews would apply to “state-sponsored” and “state-regulated health plans and health programs,” (including employer-sponsored  private insurance plans), but not Medicare Part D plans. 

Any person unhappy with decisions the board makes would be able to appeal them, and the Attorney General would then have the authority to enforce the provisions of the bill, as well.

Additionally, manufacturers of prescription drugs would be required to report prices to the board annually.

A similar bill was introduced in the Virginia Senate during the 2023 legislative session, but Republican lawmakers blocked it from passing. In doing so, they helped pharmaceutical companies who have argued in the past that a board with review and price oversight powers would have a “chilling effect” on investment in the state’s drug research and development industry. 

Over the last decade, Virginians have been shouldering a much greater burden than the average American when it comes to drug costs.

In 2020, they spent 36% more per person on prescription drugs than the national average, according to a study conducted by Altarum, a nonprofit research and consulting organization. From 2015 to 2020, Virginians’ average spending on prescription drugs rose from $1,400 to $1,500 per year, a 6.6% increase and more than twice the national increase. And in 2023 alone, Virginians spent a combined $3.2 billion on prescription drugs in the commercial market. 

A 2022 Mason Dixon poll showed that 82% of Virginians support the establishment of a Prescription Drug Affordability Board, and 56% of them felt “negative effects” due to the rising cost of medicine. A more recent 2023 survey conducted in June by the Wason Center for Civic Leadership at Christopher Newport University, found similar support, with 75% of Virginia voters supporting the creation of a prescription drug affordability board.

“This survey should show every candidate running for the General Assembly this fall that supporting a Prescription Drug Affordability Board is a commonsense bipartisan way to win voters to their side,” State AARP Director Jim Dau said last year prior to the 2023 legislative elections. 

On the federal level, the Biden administration is fighting back against high drug costs as well.

The Inflation Reduction Act reformed Medicare to lower drug costs for many of the roughly 1.1 million Virginia seniors with Medicare Part D coverage, which covers prescription drugs. For example, the bill implemented a $35 monthly cap on insulin for Medicare recipients, and as a result 36,461 Virginia seniors on Medicare who use insulin are now charged no more than $35 per month for an insulin prescription.

The IRA will also implement a $2,000 cap on Medicare recipients’ annual out-of-pocket prescription drug costs, beginning in 2025. In Virginia, an estimated 390,400 seniors are expected to save $441 a year each due to this provision, according to an analysis by the US Department of Health and Human Services.

The legislature has yet to have a hearing on HB 570, which has been referred to the Health and Human Services Subcommittee.