The sweeping federal bill aimed at cutting prescription drug costs follows years of action at the state level
Congress’ passage of a sweeping bill that will help millions of Medicare enrollees better afford life-sustaining medications was fueled by a blizzard of recent legislation to make prescription drugs more affordable at the state level. State lawmakers have introduced hundreds of bills aimed at lowering prescription drug costs in the past five years, with more than 230 measures enacted across all 50 states.
The Inflation Reduction Act of 2022 will allow Medicare to negotiate prices of some high-cost drugs for the first time, put an annual limit on Medicare Part D beneficiaries’ out-of-pocket costs, and impose tax penalties on drugmakers that increase prices more than the rate of inflation, among other things.
The move follows decades of advocacy for drug affordability by AARP and others, which until recently yielded progress mostly at the state level. “States are the laboratories of democracy,” says Jonathan Bartholomew, a government affairs director at AARP. “They’ve come up with really creative ideas to dissect, legislate and regulate this complicated and confusing marketplace, and I think that progress has really helped build federal momentum around this issue.”
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Though states are restricted by federal law in how far they can go in directly reducing drug prices, they’ve worked to improve transparency around drug pricing, cap costs for consumers, bolster their drug-purchasing power and more. And collectively, they’ve spotlighted drug affordability as a national issue that calls for federal solutions.
Here are some key state initiatives that advanced prescription drug affordability in recent years.
Increasing price transparency
For states to pinpoint what’s driving price hikes in prescription drugs, it helps to have access to pricing data across a drug’s often long and convoluted supply chain. It’s why 14 states have passed drug price transparency laws that order manufacturers, wholesalers, pharmacy benefit managers (PBMs), insurers and others to share cost information.
What pharmaceutical companies must report about their products differs between states, but common requirements include advance notice and justification of the initial price of a drug and when prices increase above certain thresholds; summaries of the state’s most prescribed and costly drugs; and rebate and reimbursement amounts for PBMs, which health insurers use to manage their prescription drug benefits.
Most of the data collected is made public, which can help doctors, consumers and other health care stakeholders. Advance notice of price hikes gives doctors and patients time to analyze patient care plans and adjust as necessary. Summaries of the most prescribed and costly drugs can show state officials where to focus reforms.
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